摘要
目的探讨慢性肾脏病（CKD）5期患者桡动脉中核心结合因子（Cbfα-1）和Ⅱ型胶原（ColⅡ）表达及其与血管钙化发生的关系。方法40例CKD5期患者在接受动-静脉内瘘手术时，留取一段桡动脉。对10例在本院接受胃大部切除术、肾功能正常患者，留取一段胃左动脉为对照组。钙盐沉积采用von Kossa染色法，根据yonKossa染色结果，CKD5期组又分为CKD5期无钙化组、轻中度钙化组和重度钙化组。Cbfα-1和ColⅡ的表达采用免疫组化染色法。同时测定血钙、磷、甲状旁腺激素（iPTH）、C反应蛋白（CRP）水平。结果40例CKD5期患者中有17例（42．5％）出现血管钙化，主要发生在血管中膜，对照组均未见血管钙化发生。CKD5期轻中度钙化组和重度钙化组中，动脉中膜均有Cbfα-1、ColⅡ的阳性表达；23例CKD5期无钙化组中，有18例（78．3％）至少有Cbfα-1、ColⅡ其中一种的阳性表达。对照组均无Cbfα-1、Col Ⅱ的阳性表达。CKD5期轻中度钙化组和重度钙化组，血管中膜Cbfα-1、ColⅡ免疫组化的阳性率均显著高于CKD5期无钙化组，但轻中度钙化组和重度钙化组之间的差异无统计学意义。CRP、钙磷乘积与Cbfα-1、ColⅡ呈正相关；血磷与Cbfα-1（r=0．786，P〈0．01）、ColⅡ（r=0．785，P〈0．01）呈正相关。结论CKD5期患者桡动脉钙化以中膜为主，钙化的动脉均有Cbfα-1、ColⅡ的高表达，且其表达早于组织学上血管钙化的发生。Cbfα-1和ColⅡ可能在血管钙化的发生、发展中起到了重要作用。
Objective To study the relationship between the medial artery calcification and expression of core-binding factor alpha 1 （Cbfα- 1） and collagen Ⅱ （Col Ⅱ ） in chronic kidney disease （CKD） stage 5 patients. Methods Pieces of radial arteries were taken from 40 patients with CKD stage 5 during internal arteriovenous fistula operation. Ten patients with subtotal gastrectomy and normal renal function were chosen as control. The vessels were examined for calcification by yon Kossa stain and for the presence of Cbfα- 1 and Col α by immunohistoehemistry. According to yon Kossa stain, CKD stage 5 patients were divided into no calcification group, mild-moderate calcification group and severe calcification group. Other related factors including serum calcium, phosphate, intact parathyroid hormone （iPTH）, C- reactive protein （CRP）, triglyeeride（TG）, cholesterol（TC） and low- density lipoproteins（LDL） were also detected. Results Seventeen （42.5%） of CKD Stage 5 patients showed vascular calcification, while calcification was not found in controls. Most calcification occurred in medial layer. Positive immunohistochemical staining of core-binding factor and Col Ⅱ was found inthe smooth muscular cell plasma of medial layer in the vessels with calcification. However, above positive staining was also observed in 78.3% of no calcification group. But there was little staining in control group. Positive staining score of Cbfα- 1 and Col Ⅱ in severe calcification group was significantly higher than that in no calcification group. Same findings were obtained in mild-moderate calcification group, but the difference between them was not statistically significant. CRP and Ca×P were positively correlated with staining score of Cbfα- 1 and Col Ⅱ. Serum phosphate was positively correlated with Cbfα- 1 （r=0.786, P〈0.01） and Col Ⅱ （r=0.785, P〈0.01） respectively. Conclusions 42.5% of CKD stage 5 patients in our group shows vascular calcification, which occurrs mainly in medial lay
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2012年第11期868-872,共5页
Chinese Journal of Nephrology
基金
福建省科技计划重点项目（2009Y0040）
关键词
核心结合因子α1亚基
胶原Ⅱ型
肾功能不全
慢性
血管钙化
高
血磷
Core binding factor alphal snbunit
Collagen type Ⅱ
Ranal insnfficiency, chronic
Vascular calcification
Hyperphosphatemia
