血清Sclerostin、OPN、Klotho蛋白、BMP-7水平与维持性血液透析患者血管钙化的关系研究

目的:探讨血清骨硬化蛋白(Sclerostin)、骨桥蛋白(OPN)、Klotho蛋白、骨形态发生蛋白7(BMP-7)水平与维持性血液透析患者血管钙化的关系。方法:选取2018年4月~2020年4月期间我院收治的109例维持性血液透析患者,经CT检查患者的血管钙化情况分为钙化组(48例)和非钙化组(61例),另选同期在我院进行体检的健康志愿者50例为对照组,对各组血清Sclerostin、OPN、Klotho蛋白、BMP-7水平进行检测对比。分析维持性血液透析患者血管钙化的影响因素。结果:钙化组、非钙化组血清Sclerostin、OPN水平高于对照组且钙化组以上指标水平高于非钙化组(P<0.05),钙化组、非钙化组血清Klotho蛋白、BMP-7水平低于对照组且钙化组以上指标水平低于非钙化组(P<0.05)。经单因素分析显示,维持性血液透析患者血管钙化与血清Sclerostin、OPN、Klotho蛋白、BMP-7有关(P<0.05)。经多因素Logistic回归分析显示,血清Sclerostin、OPN、Klotho蛋白、BMP-7是维持性血液透析患者血管钙化发生的影响因素(P<0.05)。结论:维持性血液透析患者通常伴随着血清Sclerostin、OPN水平升高,Klotho蛋白、BMP-7水平降低,且血清Sclerostin、OPN、Klotho蛋白、BMP-7是其血管钙化的影响因素,临床工作中应结合以上因素对此类患者进行针对性干预,预防其血管钙化的发生。

The Relationship between Serum Levels of Sclerostin, Osteopontin, Klotho and Bone Morphogenetic Protein 7 and Vascular Calcification in Maintenance Hemodialysis Patients

ABSTRACT Objective: To study the relationship between serum levels of osteosclerotin(Sclerostin), osteopontin(OPN), Klotho protein, bone morphogenetic protein(BMP)-7 and vascular calcification in maintenance hemodialysis patients. Methods: 109 cases of maintenance hemodialysis patients treated in our hospital from April 2018 to April 2020 were selected, the calcification of the patients was divided into calcification group (48 cases) and non calcification group (61 cases) accordding to the CT examine, and 50 healthy subjects were selected as the control group. Serum levels of sclerostin, OPN, Klotho protein and BMP-7 were detected and compared in each group. To analyze the influencing factors of vascular calcification in maintenance hemodialysis patients. Results: Serum levels of Sclerostin and OPN in calcification group and non calcification group were higher than those in control group and the above indexes in calcification group were higher than those in non-calcification group (P<0.05). The levels of serum Klotho protein and BMP-7 in the calcification group and non calcification group were lower than those in the control group, and the levels of above indicators in the calcification group were lower than those in the non calcification group (P<0.05). Univariate analysis showed that vascular calcification in maintenance hemodialysis patients was related to serum Sclerostin, OPN, Klotho protein and BMP-7 (P<0.05). Multivariate Logistic regression analysis showed that serum Sclerostin, OPN, Klotho protein and BMP-7 were the influencing factors of vascular calcification in maintenance hemodialysis patients(P<0.05). Conclusion: Maintenance hemodialysis patients are usually accompanied by increased serum levels of Sclerostin and OPN, decreased levels of Klotho protein and BMP-7, and serum Sclerostin, OPN, Klotho protein and BMP-7 are the influencing factors of their vascular calcification. In clinical work, targeted intervention should be carried out in combination with the above factors to prevent the occurrence of vascular calcification in such patients.