腹膜透析患者血管钙化的相关因素分析

Relationship of Osteoprotegerin and Vascular Calcification in Peritoneal Dialysis Patients

[目的]观察腹膜透析患者血管钙化的发生情况并探讨导致血管钙化的相关因素。[方法]利用彩超对腹膜透析患者颈内动脉斑块及内膜厚度进行测量，根据颈内动脉斑块钙化程度分为斑块组和无斑块组，并检测比较两组患者骨保护素（OPG）及血管钙化相关的临床指标。[结果]40例腹膜透析患者，有60％患者有颈内动脉内膜增厚钙化，其中斑块组和无斑块的病人相比，糖尿病比例更高，年龄较大；斑块组OPG、C反应蛋白（CRP）、血磷明显高于非斑块组，且两组相比差异有显著性（均P〈0．01）。颈内动脉厚度与OPG呈正相关（R=0．332）。[结论]腹膜透析患者普遍存在血管钙化，其与透析患者微炎症状态、高血磷有关，OPG水平可较好地反映血管钙化程度。

[Objective] To observe the relationship of osteoprotegerin and vascular calcification in peritoneal dialysis patients. [Methods] Forty peritoneal dialysis patients were enrolled in this study. Vascular calcification was evaluated by color duplex echoangiography of internal carotid artery. Demographic and clinical data were collected. Serum level of OPG was measured with ELISA method. [Results] Vascular calcification on echoangiography presented in 24 cases（60%） found to have calcification on internal carotid artery. Cardiovascular calcification usually occurred in diabetic （ P 〈0.01） and elderly patients （ P〈0.05）. The concentration of plasma osteoprotegerin and C-reactive protein （CRP） were higher in plaque patients than those in non-plaque patients （ P d0.01）. [Conclusion] Vascular calcification is commonly present in peritoneal dialysis patients. It is related to inflammation and hyperphosphatemia. The concentration of osteoprotegerin probably reflects the cardiovascular calcification in peritoneal dialysis patients.