血管内皮生长因子基因多态性对腹膜透析患者固有腹膜高转运的影响

The effect of gene polymorphism of vascular endothelial growth factor on intrinsically high peritoneal transport status in peritoneal dialysis patients

目的探讨血管内皮生长因子（VEGF）基因多态性对腹膜透析患者固有腹膜高转运的影响。方法回顾性分析2011年1月～2014年6月因终末期肾脏病行腹膜透析（PD）置管的194例患者的临床资料，按照透析开始后的腹膜转运特性将其分为低转运组（21例）、低平均转运组（55例）、高平均转运组（93例）和高转运组（25例）4组，比较患者人口学资料、透析前的生化指标以及VEGF基因单核苷酸多态性（405G／C、936C／T、-1154G／A、-2578C／A）；Logistic回归分析患者腹膜高转运的独立危险因素。结果4组患者在性别分布、心血管并发症以及C反应蛋白水平和钙磷乘积差异有统计学意义（P〈0．05）；4组患者中，VEGF基因936C／T、-1154G／A、-2578C／A多态性分布差异无统计学意义（P〉0．05）；VEGF基因405G／C多态性分析显示，在高转运和高平均转运患者与低转运和低平均转运患者中分布差异有统计学意义（P〈0．05）；回归分析结果显示，VEGF基因405G／C、936C／T、-1154G／A、-2578C／A多态性均不是本组患者腹膜高转运的独立危险因素。结论患者心血管并发症、钙磷乘积、C反应蛋白水平是影响固有腹膜高转运的独立危险因素。而VEGF基因多态性并不能独立预测本组患者的固有腹膜高转运，其对PD患者腹膜转运功能的影响需要进一步研究。

Objective To investigate the association of gene polymorphism of vascular endothelial growth factor （VEGF） and intrinsically high peritoneal transport status in peritoneal dialysis （ PD ） patients. Methods During the period of January 2011 to June 2012,194 newly started PD patients were included in this study. Patients were divided into four groups：low （L）, low average （LA）, high average （HA） and high（H） peritoneal transport rate groups, according to their categories of peritoneal transport rate defined by the result of peritoneal equilibration test（PET） at 8-12 weeks after PD. The clinical data and VEGF genotypes were compared across the groups. And multiple Logistic regression analysis was used to determine the independent factors associated with high peritoneal transport status. Results Significant difference in the gender, history of cardiovascular complications, serum levels of C-reaction protein and calcium phosphorus product were found among the groups（ P 〈 0.05 ）. No difference was found on the distribution of VEGF 936C/T, - 1154G/A and - 2578C/A polymorphism among groups （ P 〉 0. 05 ）. Patients in H/HA groups had a higher frequency of VEGF 405CC genotype than those in L/LA groups （ P 〈 0.05 ）. Logistic regression analysis showed none of the four VEGF polymorphisms was the independ- ent risk factor for high peritoneal transport status （P 〈 0.05）. Conclusion It is cardiovascular complications, serum levels of C-reaction protein and calcium phosphorus product, but not VEGF polymorphisms that are independent risk factors for intrinsically high peritoneal transport status in peritoneal dialysis patients in our center. The role of VEGF polymorphism on the intrinsically high peritoneal transport status should be further examined.