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中华肾病研究电子杂志 ›› 2024, Vol. 13 ›› Issue (05) : 256 -260. doi: 10.3877/cma.j.issn.2095-3216.2024.05.003

论著

维持性血液透析患者血清β-CTX、N-MID 和PICP 与冠状动脉钙化的关系及其诊断价值
周敏1,(), 徐阳1, 胡莹1, 黄先凤1   
  1. 1.448001 荆门市中医医院血液净化中心
  • 收稿日期:2024-05-28 出版日期:2024-10-28
  • 通信作者: 周敏
  • 基金资助:
    荆门市中医医院科研计划项目(2024ZYYKY022)

Relationship of serum β-CTX,N-MID,and PICP with coronary artery calcification in maintenance hemodialysis patients and its diagnostic value

Min Zhou1,(), Yang Xu1, Ying Hu1, Xianfeng Huang1   

  1. 1.Blood Purification Center, Jingmen Hospital of Traditional Chinese Medicine, Jingmen 448001, Hubei Province,China
  • Received:2024-05-28 Published:2024-10-28
  • Corresponding author: Min Zhou
引用本文:

周敏, 徐阳, 胡莹, 黄先凤. 维持性血液透析患者血清β-CTX、N-MID 和PICP 与冠状动脉钙化的关系及其诊断价值[J/OL]. 中华肾病研究电子杂志, 2024, 13(05): 256-260.

Min Zhou, Yang Xu, Ying Hu, Xianfeng Huang. Relationship of serum β-CTX,N-MID,and PICP with coronary artery calcification in maintenance hemodialysis patients and its diagnostic value[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2024, 13(05): 256-260.

目的

探讨维持性血液透析(MHD)患者血清Ⅰ型胶原β-异构化C 端肽(β-CTX)、骨钙素N 端中分子片段(N-MID)和Ⅰ型前胶原羧基端前肽(PICP)与冠状动脉钙化的关系及其诊断价值。

方法

该研究为横断面研究,以2021 年5 月至2023 年5 月在本院进行诊治的80 例MHD 患者为研究对象,根据Agatston 评分将其分为钙化组(47 例)和无钙化组(33 例)。 收集患者的基本信息、合并症以及血清钙、磷、β-CTX、N-MID 及PICP 水平等资料。 Logistic 回归方法分析冠状动脉钙化的影响因素;采用受试者操作特征(ROC)曲线分析血清β-CTX、N-MID 和PICP 对冠状动脉钙化的诊断价值。

结果

与无钙化组相比,钙化组的血清磷、N-MID 和PICP 水平较高,而β-CTX 水平较低(t =2.300、t=4.653、t=4.689、t=4.236,P 均<0.05);Logistic 分析显示,血清磷、β-CTX、N-MID 和PICP均为MHD 患者冠状动脉钙化的影响因素(OR =2.145,95%CI:1.217 ~3.779;OR =0.593,95%CI:0.436 ~0.807;OR=2.142,95%CI:1.346 ~3.408;OR =1.533,95%CI:1.212 ~1.939)。 ROC 曲线分析显示,β-CTX、N-MID 和PICP 联合诊断MHD 患者冠状动脉钙化的曲线下面积(AUC)为0.951,特异度为80.0%、敏感度为83.0%。

结论

冠状动脉钙化的MHD 患者,血清β-CTX 水平显著降低,N-MID、PICP 水平均显著升高,三者联合对诊断冠状动脉钙化具有一定价值。

Objective

To investigate the relationship of β-isomerized C-terminal telopeptide of type I collagen (β-CTX),N-terminal midfragment of osteocalcin (N-MID),and procollagen type I carboxyterminal propeptide (PICP) with coronary artery calcification in patients with maintenance hemodialysis(MHD) and its diagnostic value.

Methods

A cross-sectional study on 80 patients with MHD who underwent consultation in our hospital from May 2021 to May 2023 was conducted. They were divided into a calcification group (n = 47) and a non-calcification group (n = 33) according to the Agatston scoring system. The patients' basic information,comorbidities,and serum levels of calcium,phosphorus,β-CTX,N-MID,and PICP were collected. The influencing factors for coronary artery calcification were analyzed by the logistic regression method. The diagnostic value of serum β-CTX,N-MID,and PICP in coronary artery calcification was analyzed by the receiver operating characteristic (ROC) curve.

Results

Compared with the non-calcification group,the calcification group showed obviously higher serum levels of phosphorus (t =2.300, P <0.05),N-MID (t =4.653, P <0.05),and PICP (t =4.689, P <0.05),but significantly lower serum level of β-CTX (t=4.236, P <0.05). Logistic regression analysis results showed that serum phosphorus,CTX,N-MID,and PICP were all influencing factors for the coronary artery calcification in the MHD patients (OR=2.145,95%CI: 1.217-3.779; OR =0.593,95%CI: 0.436-0.807; OR =2.142,95%CI:1.346-3.408; OR =1.533,95%CI: 1.212-1.939). ROC curve analysis showed that the area under the curve (AUC) of the combination of β-CTX,N-MID,and PICP was 0.951 for diagnosing the coronary artery calcification in the MHD patients,with the specificity and sensitivity being 80. 0% and 83.0%,respectively.

Conclusion

In the MHD patients with the coronary artery calcification,serum level of β-CTX was significantly lower,while serum levels of N-MID and PICP were significantly higher. The combination of them three was of certain value in diagnosing coronary artery calcification in the MHD patients.

图1 患者纳入和排除流程图 注:MHD:维持血液透析
表1 一般资料对比
表2 两组患者血清β-CTX、N-MID、PICP 水平对比
表3 MHD 患者冠状动脉钙化多因素logistic 回归分析
图2 血清β-CTX、N-MID、PICP 诊断MHD 患者冠状动脉钙化的ROC 曲线
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