血清色素上皮衍生因子与维持性血液透析患者冠状动脉钙化的相关性

Correlation between serum level of pigment epithelium derived factor and coronary artery calcification in patients undertaking maintenance hemodialysis

目的探讨血清色素上皮衍生因子（pigment epithelium-derived factor，PEDF）与维持性血液透析患者冠状动脉钙化（coron aryartery calcification，CAC）的关系。方法以本院2015年1月至2016年6月血液净化科进行血液透析的慢性肾病患者80例为观察对象，进行常规检查，并检测血清PEDF水平，采用多层螺旋cT（MSCT）进行冠状动脉扫描，计算CAC评分。并用SPSS17．0中的Logistic单因素回归分析判断患者CAC的影响因素。结果80例患者中CAC（CACs〉100）的患病率为73．75％，血清PEDF水平随着CAC积分的增加而降低，3组间差异具有统计学意义（P〈0．05）。Logistic回归分析发现PEDF是CAC的独立保护因素（OR=O．76，95q6CI：0．617-0．955，P=0．01）。结论血清PEDF水平和CAC的严重程度相关，高水平的PEDF是CAC的独立保护因素，可作为临床上维持血液透析患者预防心血管疾病的一个监测指标。

Objective To investigate the relationship between the serum level of pigment epithelium derived factor （ PEDF ） and coronary artery calcification （ CAC ） in patients undertaking maintenance hemodialysis. Methods 80 patients with chronic kidney disease undertaking hemodialysis at the department of blood purification at our hospital from January, 2015 to June, 2016 were selected as study objects and routinely examined. The serum level of PEDF was detected. The coronary arteries were scanned by multi-slice spiral CT （ MSCT ） . The CAC score was calculated. Logistic single factor regression analysis was operated in SPSS17.0 to analyze the influence factors of patients with CAC. Results Among the 80 patients, 73.75% had CAC （ CACs 〉 100 ） . The serum level of PEDF decreased with the increase of CAC score, with statistical differences between these three groups （ P 〈 0.05 ） . Logistic regression analysis revealed that PEDF was an independent protective factor for CAC （ OR=0.76, 95% CI 0.955 - 0.617, P=0.01 ） . Conclusions The serum level of PEDF correlates with the severity ofCAC. A high level of PEDF is an independent protective factor for CAC, which can be used as a monitoring index for the prevention of cardiovascular disease in patients undertaking maintenance hemodialysis.