中国血液净化

中国血液净化 ›› 2025, Vol. 24 ›› Issue (11): 924-928.doi: 10.3969/j.issn.1671-4091.2025.11.010

• 临床研究 • 上一篇    下一篇

慢性肾衰竭维持性血液透析患者血清干扰素基因刺激因子、沉默信息调节因子3水平与血管钙化的关系研究

钱姗姗   张小蓬    仲泳萍    陆 飞   

  1. 226100 南通，南通市海门区人民医院1临床检验中心 2肾脏内科
  • 收稿日期:2025-01-07 修回日期:2025-05-28 出版日期:2025-11-12 发布日期:2025-11-12
  • 通讯作者: 仲泳萍 E-mail:459112458@qq.com
  • 基金资助:
    江苏省卫生健康委医学科研立项项目(YB20210171)

Study on the relationship between serum levels of STING and Sirt3 and vascular calcification in patients with chronic renal failure undergoing maintenance hemodialysis#br#

QIAN Shan-shan, ZHANG Xiao-peng, ZHONG Yong-ping, LU Fei   

  1. Department of Laboratory Medicine and 2Department of Nephrology, Nantong Haimen People's Hospital, Nantong 226100, China
  • Received:2025-01-07 Revised:2025-05-28 Online:2025-11-12 Published:2025-11-12
  • Contact: 226100 南通，南通市海门区人民医院1临床检验中心 E-mail:459112458@qq.com

摘要： 目的 探讨慢性肾衰竭维持性血液透析(maintenance hemodialysis，MHD)患者血清干扰素基因刺激因子(stimulator of interferon genes，STING)、沉默信息调节因子3(silent information regulator 3，Sirt3)水平与血管钙化(vascular calcification,VC)的关系。 方法 选取2021年1月─2024年5月南通市海门区人民医院MHD患者157例(研究组)和体检健康志愿者157例(对照组)，根据MHD患者是否发生VC分为VC组和非VC组。多因素Logistic分析慢性肾衰竭MHD患者发生VC的影响因素；受试者工作特征(receiver operating characteristics，ROC)曲线评估血清STING、Sirt3水平对慢性肾衰竭MHD患者发生VC的预测价值。 结果 研究组血清STING水平高于对照组(t=15.967，P＜0.001)，Sirt3水平低于对照组(t=-19.484，P＜0.001)。VC组(n=84)血清STING水平高于非VC组(n=73)(t=6.935，P＜0.001)，Sirt3水平低于非VC组(t=-7.717，P＜0.001)。长透析龄(OR=1.052，95% CI：1.022～1.083，P=0.001)、全段甲状旁腺素水平高(OR=1.003，95%CI：1.001～1.005，P=0.003)、STING高(OR=1.083，95%CI：1.042～1.125，P＜0.001)为慢性肾衰竭MHD患者VC的独立危险因素，Sirt3高(OR=0.493，95%CI：0.342～0.709，P＜0.001)为慢性肾衰竭MHD患者VC的独立保护因素。血清STING、Sirt3水平联合预测慢性肾衰竭MHD患者VC的曲线下面积(area under the curve，AUC)为0.871，大于血清STING、Sirt3水平单独预测的0.780、0.800(Z=3.327、2.947，P=0.001、0.003)。 结论 慢性肾衰竭MHD患者血清STING水平升高、Sirt3水平降低与VC风险增加有关，二者联合检测可有效预测慢性肾衰竭MHD患者发生VC。

关键词: 慢性肾衰竭, 维持性血液透析, 干扰素基因刺激因子, 沉默信息调节因子3, 血管钙化

Abstract: Objective  To investigate the relationship between serum levels of stimulator of interferon genes (STING) and silent information regulator 3 (Sirt3) and vascular calcification (VC) in patients with chronic renal failure undergoing maintenance hemodialysis (MHD).  Methods  A total of 157 chronic renal failure patients undergoing MHD treated in Haimen District People's Hospital of Nantong City from January 2021 to May 2024 were assigned as study group, and 157 healthy volunteers for physical examination were recruited as control group. Based on the presence or absence of VC, the study group was further divided into the VC group (n=84) and the non-VC group (n=73). Multivariate logistic regression analysis was used to identify the risk factors for VC in MHD patients. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of serum STING and Sirt3 levels for VC in these patients.  Results  Compared with the control group, MHD patients had significantly higher serum STING level and lower Sirt3 level (t=15.967 and -19.484, P＜0.001). The incidence of VC among the 157 MHD patients was 53.50% (84/157). Compared with the non-VC group, the VC group showed significantly higher STING level and lower Sirt3 level (t=6.935 and -7.717, P＜0.001). Longer dialysis duration (OR=1.052, 95% CI: 1.022～1.083, P=0.001), elevated intact parathyroid hormone (iPTH) level (OR=1.003, 95% CI: 1.001～1.005, P=0.003), and elevated STING level (OR=1.083, 95% CI: 1.042～1.125, P＜0.001) were the independent risk factors for VC, while higher Sirt3 level (OR=0.493, 95% CI: 0.342～0.709, P＜0.001) was the independent protective factor for VC. The area under ROC curve (AUC) for prediction of VC using combined serum STING and Sirt3 levels was 0.871, which was significantly higher than that using STING (0.780) or Sirt3 (0.800) alone (Z=3.327 and 2.947, P=0.001 and 0.003).  Conclusion   Elevated serum STING and decreased Sirt3 are associated with an increased risk of VC in chronic renal failure patients undergoing MHD. Combined measurement of STING and Sirt3 can effectively predict the presence of VC in this patient population.

Key words: Chronic renal failure, Maintenance hemodialysis, Stimulator of interferon genes, Silent information regulator 3, Vascular calcification

中图分类号: