维持性血液透析患者血管钙化与维生素K_2摄入关系的研究

Study on the relationship between vascular calcification and vitamin K_2 intake in hemodialysis patients

目的探讨维生素K_2的摄入对降低血透患者血管钙化风险的效果。方法选择2014年5月~2016年5月于柳州市工人医院肾内科就诊的维持性血液透析患者75例作为研究对象。采用随机数字表法将其随机分为三组,分别给予不同剂量的维生素K_2,即360μg组、720μg组及1080μg组,每组25例,均分别采用维生素K_2治疗8周,计算各组患者的血管钙化评分,观察并记录各组患者治疗前后基质Gla蛋白(MGP)的表达水平,并探讨其与维生素K_2是否存在浓度相关性。本文所得数据采用SPSS 13.0进行建模处理,采用Spearman作相关性回归分析。结果与治疗前比较,治疗后三组血液透析患者血液中血管钙化评分均显著降低(P<0.05);其中,以1080μg组患者的下降率(56.16%)最为显著(P<0.05)。与治疗前比较,治疗后三组血液透析患者血液中MGP水平均明显降低(P<0.05),其中,以1080μg组患者的下降率(46.37%)最为显著(P<0.05)。另外,Spearman回归分析结果显示,摄入维生素K_2剂量与MGP水平的变化存在负相关性(r=-0.19,P<0.01);血清维生素K_2浓度与血管钙化评分呈负相关(r=-0.51,P<0.05)。结论摄入维生素K_2剂量分别与MGP水平和血管钙化评分的变化存在负相关性,表明维生素K_2的摄入可有效降低血液透析患者血管钙化的风险。

Objective To investigate the effect of vitamin K2 intake in reducing the risk of vascular calcification in hemodialysis patients. Methods Seventy-five patients with maintenance hemodialysis treated in the Department of Nephrology in Liuzhou Worker＇s Hospital from May 2014 to May 2016 were selected as research objects. According to random number method, they were randomly divided into three groups： 360 p,g group, 720 p^g group and 1080 ~g group, and 25 patients in each group were treated with vitamin K2 for 8 weeks. The vascular calcification score of each group was calculated. The expression of Gla protein （MGP） in the stroma was observed and recorded before and after treatment, and the correlation between vitamin K2 and the expression of MGP was investigated. The data were analyzed by SPSS 13.0, and Spearman regression was used to analyze the data. Results Compared with before treatment, the blood calcification score of hemodialysis patients after treatment was decreased significantly （P 〈 0.05）, and the de- scending rate of 1080 Ixg group （56.16%） was the most significant （P 〈 0.05）. Compared with before treatment, the lev- els of MGP in hemodialysis patients of the three groups were decreased significantly （P 〈 0.05）, and the descending rate of 1080 I^g group （46.37%） was the most significant （P 〈 0.05）. In addition, Spearman regression analysis showed that there was a negative correlation between the intake of vitamin K2 and MGP （r = -0.19, P 〈 0.01）; serum vitamin K2 had negative correlation with vascular calcification （r = -0.51, P 〈 0.05）. Conclusion There is a negative correlation between the intake of vitamin K2 and the changes of MGP level and vascular calcification score, suggesting that intake of vitamin K2 can effectively reduce the risk of vascular calcification in hemodialysis patients.