中国血液净化

中国血液净化 ›› 2025, Vol. 24 ›› Issue (07): 571-575,589.doi: 10.3969/j.issn.1671-4091.2025.07.006

• 临床研究 • 上一篇    下一篇

血清Nod样受体蛋白3、骨形态发生蛋白2与慢性肾脏病患者左心室肥厚的相关性研究

陈 静   张亚璞   郑喜洁   郭珊珊    陈 航   

  1. 071000 保定，1河北大学附属医院肾内科
  • 收稿日期:2024-10-17 修回日期:2025-04-03 出版日期:2025-07-12 发布日期:2025-07-12
  • 通讯作者: 陈航 E-mail:chenhang65@sina.com
  • 基金资助:
    河北省科技厅重点民生项目(20377705D)

Correlation between serum Nod-like receptor protein 3, bone morphogenetic protein 2 levels and left ventricular hypertrophy in patients with chronic kidney disease

CHEN Jing,  ZHANG Ya-pu,  ZHENG Xi-jie, GUO Shan-shan, CHEN Hang   

  1. Department of Nephrology, the Affiliated Hospital of Hebei University, Baoding 071000, China
  • Received:2024-10-17 Revised:2025-04-03 Online:2025-07-12 Published:2025-07-12
  • Contact: 071000 保定，1河北大学附属医院肾内科 E-mail:chenhang65@sina.com
  • Supported by:

摘要： 目的  探讨血清Nod样受体蛋白3(Nod-like receptor protein 3,NLRP3)及骨形态发生蛋白2(bone morphogenetic protein 2,BMP2)水平与慢性肾脏病(chronic kidney disease,CKD)患者左心室肥厚(left ventricular hypertrophy,LVH)之间的相关性。 方法  收集CKD患者102例，根据临床分期分为CKD G3组(n=31)、CKD G4组(n=27)及CKD G5组(n=44)。根据患者是否并发LVH，将研究对象分为LVH组(n=40)与非LVH组(n=62)。用酶联免疫吸附试验测血清NLRP3、BMP2水平，彩色多普勒超声诊断仪检测LVH，分析血清NLRP3、BMP2水平与LVH之间的相关性。 结果  随着CKD分期的进展，患者的血清BMP2、NLRP3水平均呈现上升趋势(H=69.424、49.945，均P＜0.001)。相关性分析显示，CKD患者血清NLRP3与BMP2(rs=0.661,P＜0.001)、左心室质量指数(rs=0.495,P＜0.001)呈正相关。此外，与非LVH组相比，LVH组血清BMP2、NLRP3水平均明显升高(Z =-3.555、-5.737，均P＜0.001)。Logistic回分析显示，血清BMP2(OR=1.039,95% CI：1.013～1.066,P=0.003)、NLRP3(OR=1.007,95% CI：1.004～1.010,P＜0.001)水平升高是影响CKD患者LVH的危险因素，而血清NLRP3水平升高则是CKD患者LVH的独立危险因素(OR=1.006,95% CI：1.003～1.010,P=0.001)。受试者工作特征曲线分析显示，NLRP3预测G3～5 CKD患者LVH的曲线下面积为0.838，敏感度为77.42%，特异度为82.50%，最佳切点为881.80 ng/L。 结论  血清BMP2水平升高为影响CKD患者LVH的重要危险因素，而NLRP3水平升高则是CKD患者LVH的独立危险因素。

关键词: 慢性肾脏病, 左心室肥厚, NOD样受体蛋白3, 骨形态发生蛋白2

Abstract: Objective  To investigate the correlation between serum levels of serum Nod-like receptor protein 3 (NLRP3) and bone morphogenetic protein 2 (BMP2) and the left ventricular hypertrophy (LVH) in patients with chronic kidney disease (CKD).  Methods  A total of 102 patients with CKD were collected and categorized into CKD stage 3 group (n=31), stage 4 group (n=27) and stage 5 group (n=44). According to the presence of LVH, patients were further divided into LVH group (n=40) and non-LVH group (n=62). Serum NLRP3 and BMP2 were measured by enzyme-linked immunosorbent assay (ELISA). LVH was detected by color Doppler ultrasound. The correlation between serum NLRP3 and BMP2 levels and LVH was analyzed. Results   As CKD progressed, serum BMP2 and NLRP3 levels showed an upward trend (H=69.424, 49.945; both P＜0.001). Correlation analysis showed that serum NLRP3 level was positively correlated with BMP2 and left ventricular mass index in CKD patients (rs=0.661, 0.495; both P＜0.001). Compared with the non-LVH group, the LVH group exhibited significantly higher serum BMP2 and NLRP3 levels (Z=-3.555, -5.737; both  P＜0.001). Logistic regression analysis showed that elevated serum BMP2 (OR=1.039, 95% CI:1.013～1.066, P=0.003) and NLRP3 (OR=1.007, 95% CI:1.004～1.010, P＜0.001) levels were risk factors for LVH in CKD patients , with NLRP3 being an independent risk factor (OR=1.006, 95% CI:1.003～1.010, P=0.001). Receiver operating characteristic (ROC) curve analysis demonstrated that NLRP3 predicted LVH in stage 3～5 CKD patients with an area under the curve (AUC) of 0.838, sensitivity of 77.42%, specificity of 82.50%, and an optimal cutoff value of 881.80 ng/L. Conclusions  Elevated serum BMP2 level is an important risk factor for LVH in CKD patients, while elevated NLRP3 level serves as an independent risk factor.

Key words: Chronic kidney disease, Left ventricular hypertrophy, NOD-like receptor protein 3, Bone morphogenetic protein 2

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