【摘要】目的 观察CKD5期非透析的糖尿病和非糖尿病患者血管钙化的发生情况，探讨糖尿病在CKD患者血管钙化中所扮演的角色。 方法 收集入选CKD5期非透析的糖尿病和非糖尿病患者人口学及临床资料，通过腹部、骨盆、手部X线平片进行血管钙化的定量测量，检测血压、相关血生化指标和全段甲状旁腺素(iPTH)水平，进行相关分析。 结果 入选68例CKD5期非透析患者，其中糖尿病患者32例、非糖尿病患者36例。X线平片显示42.6%(29/68例)有不同程度、不同部位的血管钙化，存在血管钙化的患者中82.8%有腹主动脉钙化，37.9%存在中小动脉(包括髂动脉、股动脉、桡动脉、手指动脉)钙化。糖尿病CKD患者血管钙化发生率及钙化程度明显高于非糖尿病患者，且腹主动脉及中、小动脉钙化发生率均明显高于非糖尿病患者(P＜0.05)。血管钙化的Logistic回归显示年龄和糖尿病是CKD5期非透析患者血管钙化的独立危险因素。结论 与非糖尿病患者相比，患有糖尿病的CKD5期非透析患者各部位存在较高的血管钙化发生率及较重的血管钙化程度。糖尿病在CKD患者血管钙化中扮演了重要角色。

【Abstract】 Objective To investigate the status of vascular calcification in nondialysed stage 5 chronic kidney disease (CKD) patients and to explore the role of diabetes on vascular calcification in CKD patients. Methods Vascular calcification was quantitatively evaluated by plain radiographic films from abdomen, pelvis and hands. Demographic and clinical data were collected. The parameters relating to vascular calcification were then analyzed. Results In this study we analyzed 68 nondialysed stage 5 CKD patients including 36 non-diabetic and 32 diabetic patients. Among the 68 patients, vascular calcification was found on radiographic films in 29 cases (42.6%), of which 82.8% had calcification of abdominal aorta and 37.9% showed calcification of peripheral muscular arteries. Logistic regression revealed that age and diabetes were the independent risk factors for vascular calcification in nondialysed stage 5 CKD patients. The prevalence and degree of vascular calcification were higher in the patients with diabetes than those without diabetes (P＜0.05), and so did the prevalence of calcification of abdominal aorta and peripheral muscular arteries (P＜0.05). Conclusions The undialyzed stage 5 CKD patients with diabetes have higher prevalence rate and more severity of vascular calcification than those without diabetes. Diabetes therefore plays an important role in vascular calcification in CKD patients.