摘要
目的:探讨血清锌-α2-糖蛋白(ZAG)在维持性血液透析(MHD)患者冠状动脉钙化诊断中的价值。方法:选取2017年3月至2019年3月,在我院行MHD治疗的患者152例,收集临床资料,利用全自动生化分析仪检测血钙、血磷、血脂(TC、TG、LDL-C、HDL-C)、肝功能(谷丙转氨酶、谷草转氨酶)、白蛋白、血肌酐、血尿酸、尿素氮、全段甲状旁腺素,利用酶联免疫吸附试验(ELISA法)检测血清中ZAG水平,所有患者均接受64排螺旋CT扫描检查,利用Agatston评分软件对图像进行量化评估,根据冠状动脉钙化积分,将患者分为无钙化组(n=59)和钙化组(n=93)。结果:与无钙化组相比,钙化组患者年龄、高血压比例、血磷、血肌酐和hs-CRP升高,而ZAG降低,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,年龄、高血压、血肌酐、hs-CRP和ZAG是影响MHD患者冠状动脉钙化的危险因素(P<0.05);MHD患者冠状动脉钙化评分与年龄和hs-CRP呈正相关(r=0.290和0.451,P<0.05),与ZAG呈负相关(r=-0.537,P<0.05);ROC曲线分析结果显示,血清ZAG水平在预测MHD患者发生冠状动脉钙化时,曲线下面积0.821(95%CI:0.753~0.888),当血清ZAG水平取46.34 mg/L时,灵敏度为87.10%,特异度为64.41%。结论:MHD患者血清ZAG水平与冠状动脉钙化相关,且对MHD患者发生冠状动脉钙化具有一定的诊断价值。
Objective: To investigate the value of serum zinc-α2-glycoprotein(ZAG) in the diagnosis of coronary artery calcification in patients with maintenance hemodialysis(MHD). Methods: A total of 152 cases of patients who underwent MHD treatment in our hospital were selected from March 2017 to March 2019. The clinical data was collected. The blood calcium, blood phosphorus, blood lipids(TC\,TG\,LDL-C\,HDL-C), liver function(alanine aminotransferase, aspartate aminotransferase), albumin, blood creatinine, blood uric acid, urea nitrogen, whole parathyroid hormone were detected by using automatic biochemical analyzer. The serum levels of ZAG were detected by using enzyme-linked immunosorbent assay(ELISA). All patients accepted 64-slice spiral CT scan, and the images were quantitatively evaluated using Agatston scoring software. According to the coronary artery calcification score, patients were divided into non-calcification group(n=59) and calcification group(n=93). Results: Compared with the non-calcification group, the age, proportion of hypertension, blood phosphorus, serum creatinine and hypersensitive-C reactive protein in the calcification group were increased, while the ZAG was decreased, the difference were statistically significant(P<0.05). The result of multivariate logistic regression analysis showed that age, hypertension, blood creatinine, hs-CRP and ZAG were independent risk factors for coronary artery calcification in patients with MHD(P<0.05). The coronary artery calcification score in MHD patients was positively correlated with the age and hypersensitive-C reactive protein(r=0.290 and 0.451, P<0.05), while was negatively correlated with ZAG(r=-0.537, P<0.05). ROC curve analysis result show that when the serum level of ZAG in predicting coronary artery calcification in patients with MHD, the area under the curve was 0.821(95% CI: 0.753-0.888), when the serum level of ZAG was 46.34 mg/L, the sensitivity was 87.10%, specificity was 64.41%. Conclusions: The serum level of ZAG in patients with MHD is associat
作者
陈桢
高丽萍
苏红
CHEN Zhen;GAO Liping;SU Hong(Department of Renal Rheumatology,Shekou People’s Hospital,Shenzhen 518067,China)
出处
《心肺血管病杂志》
2020年第10期1208-1212,共5页
Journal of Cardiovascular and Pulmonary Diseases
基金
湖北省重点实验室开放基金(SB201402)。
关键词
维持性血液透析
锌-α2-糖蛋白
冠状动脉钙化
诊断价值
Maintenance hemodialysis
Zinc-α2-glycoprotein
Coronary artery calcification
Diagnostic value
