摘要
目的探讨终末期肾病(end-stage renal disease,ESRD)维持性血液透析(maintenance hemodialysis,MHD)患者血清Sortilin(SORT)、胰岛素样生长因子-1(insulin-like growth factor 1,IGF-1)水平与心血管疾病(cardiovasculardisease,CVD)发生和预后的相关性。方法选取2017年2月~2018年2月昆山市第一人民医院诊治的84例终末期肾病MHD患者为MHD组。随访5年,根据是否并发CVD将MHD组分为CVD组(n=35)和非CVD组(n=49),以同期体检的60例健康人为对照组。酶联免疫吸附实验(ELISA)法检测血清SORT和IGF-1水平。多因素Logistic回归分析终末期肾病MHD患者并发CVD的影响因素。受试者工作特征(ROC)曲线分析血清SORT和IGF-1对终末期肾病MHD患者并发CVD的预测价值。Kaplan-Meier生存分析血清SORT,IGF-1水平与终末期肾病MHD患者生存率的相关性。结果相比于对照组,MHD组血清SORT水平(413.37±55.41 ng/L vs 81.27±24.69 ng/L)较高,血清IGF-1水平(117.64±18.42μg/L vs 421.34±14.58μg/L)较低,差异具有统计学意义(t=43.416,106.122,均P<0.001)。CVD组患者年龄、透析时间、血清SORT(488.73±55.41 ng/L vs 359.54±58.29 ng/L)高于非CVD组,血清IGF-1(88.25±17.92μg/L vs 138.63±19.55μg/L)低于非CVD组,差异具有统计学意义(t=2.896,2.588,10.221,12.050,均P<0.05)。年龄(OR=1.548,P<0.001)、透析时间(OR=1.616,P<0.001)和血清SORT(OR=1.353,P=0.000)是影响MHD患者并发CVD的独立危险因素,血清IGF-1(OR=0.742,P<0.001)是保护因素。血清SORT和IGF-1联合检测预测MHD患者并发CVD的曲线下面积(95%CI)为0.931(0.895~0.961),大于SORT和IGF-1单项指标检测[0.843(0.810~0.889),0.887(0.833~0.921)],差异具有统计学意义(Z=5.117,4.895,均P<0.001)。SORT高表达组MHD患者五年累积生存率(48.39%)低于低表达组(84.81%),IGF-1低表达组MHD患者五年累积生存率(51.52%)低于高表达组(84.31%),差异具有统计学意义(Log-Rankχ2=18.670,8.900,均P<0.01)。结论MHD患者血清SORT水平升高,IGF-1水平降低,两者联合�
Objective To investigate the correlation between serum Sortilin(SORT)and insulin-like growth factor 1(IGF-1)levels and the occurrence and prognosis of cardiovascular disease(CVD)in maintenance hemodialysis(MHD)patients with endstage renal disease(ESRD).Methods Eighty-four MHD patients with ESRD diagnosed and treated in the First People’s Hospital of Kunshan from February 2017 to February 2018 were selected as the MHD group.With 5 years of follow-up,the MHD group was divided into the CVD group(n=35)and the non-CVD group(n=49)according to whether they had concurrent CVD,while 60 healthy individuals who underwent physical examination during the same period were used as the control group.Enzymelinked immunosorbent assay was used to detect serum SORT and IGF-1 levels.Multivariate logistic regression analysis was conducted to investigate the influencing factors of CVD in MHD patients with ESRD.The predictive value of serum SORT and IGF-1 for CVD in MHD patients with ESRD was analyzed by the receiver operating characteristic curve.The correlation between serum SORT and IGF-1 levels and the survival rate of MHD patients with ESRD was analyzed by Kaplan-Meier survival analysis.Results Compared to the control group,the MHD group had higher serum SORT level(413.37±55.41 ng/L vs 81.27±24.69 ng/L)and lower serum IGF-1 level(117.64±18.42μg/L vs 421.34±14.58μg/L),with significant differences(t=43.416,106.122,all P<0.001).The age,dialysis time,and serum SORT level(488.73±55.41ng/L vs 359.54±58.29ng/L)of patients in the CVD group were higher than those in the non-CVD group,while serum IGF-1 level(88.25±17.92μg/L vs 138.63±19.55μg/L)was lower than that of the non-CVD group,with significant differences(t=2.896,2.588,10.221,12.050,all P<0.05).Age(OR=1.548,P<0.001),dialysis time(OR=1.616,P<0.001)and serum SORT(OR=1.353,P<0.001)were independent risk factors for CVD in MHD patients,while serum IGF-1(OR=0.742,P=0.000)was a protective factor for CVD in MHD patients.The area under the curve(95%CI)of the combined serum SORT a
作者
封建华
叶建明
赵毅
郁丽霞
FENG Jianhua;YE Jianming;ZHAO Yi;YU Lixia(Department of Nepehrology,the First People’s Hospital of Kunshan,Jiangsu Kunshan 215300,China)
出处
《现代检验医学杂志》
CAS
2024年第3期125-130,共6页
Journal of Modern Laboratory Medicine
基金
江苏省卫生健康委医学科研立项项目(S2022213)。
