维持性血液透析患者血清HIF-1α VEGF水平与冠状动脉钙化的相关性

Correlations Between Levels of Serum HIF-1α and VEGF with Coronary Artery Calcification in Maintenance Hemodialysis Patients

目的:检测维持性血液透析(MHD)患者血清缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)的水平,并探讨二者与冠状动脉钙化(CAC)的关系。方法:选取在我院进行MHD患者88例作为MHD组,并按照Framingham危险评分(FRS)分为低危组、中危组和高危组;同时期选取56例体检健康者作为参照组。利用酶联免疫吸附试验(ELISA)检测两组血清HIF-1α、VEGF水平,CAC以冠状动脉钙化积分(CACs)进行评定,分析MHD患者血清HIF-1α、VEGF水平与CACs积分之间的关系。结果:与参照组比较,MHD组吸烟率、血红蛋白(Hb)、血糖(GLU)、C反应蛋白(CRP)、甘油三酯(TG)及高密度脂蛋白胆固醇(HDLC)水平均差异显著(P<0.05);MHD组血清HIF-1α及VEGF含量远高于参照组(P<0.05);高危组、中危组血清HIF-1α、VEGF水平及CACs积分明显高于低危组(P<0.05),高危组血清HIF-1α、VEGF水平、CACS显著高于中危组(P<0.05);MHD患者血清HIF-1α、VEGF水平与CACs积分呈明显正相关(r=0.778,0.747,P<0.05);多因素回归分析显示,HDLC、FRS、HIF-1α、VEGF及CRP均为CACS的主要影响因素。结论:血清HIF-1α、VEGF水平在MHD患者均呈现高表达,均与CACS有一定的关系,可能参与MHD患者冠状动脉钙化的发生发展。

Objective: To detect the levels of serum hypoxia inducible factor-1α(HIF-1α) and vascular endothelial growth factor (VEGF) in patients with maintenance hemodialysis (MHD), and to explore the relationships between them with coronary artery calcification (CAC). Methods: 88 patients with MHD in our hospital were selected as MHD group and divided into low-risk group, middle-risk group and high-risk group according to Framingham risk score (FRS);at the same time, 56 healthy persons were selected as the control group. Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of serum HIF-1 and VEGF in two groups, CAC was evaluated by coronary artery calcification score (CACs), the relationships between levels of serum HIF-1, VEGF with CACs in MHD patients were analyzed. Results: Compared with the control group, the smoking rate, hemoglobin (Hb), blood glucose (GLU), C reactive protein (CRP), triglyceride (TG) and high-density lipoprotein cholesterol (HDLC) levels in MHD group were significantly different (P<0.05);the levels of serum HIF-1 and VEGF in group MHD were much higher than those in reference group (P<0.05);the levels of serum HIF-1α, VEGF and CACs score in high-risk group and middle-risk group were significantly higher than those in low-risk group (P<0.05), the levels of serum HIF-1α, VEGF and CACs in high-risk group were significantly higher than those in middle-risk group (P<0.05);the levels of serum HIF-1α and VEGF in MHD patients were positively correlated with CACs (r=0.778, 0.747, P<0.05);multivariate regression analysis showed that HDLC, FRS, HIF-1α, VEGF and CRP were the main influencing factors of CACS. Conclusion: The levels of serum HIF-1α and VEGF are high in patients with MHD, which is related to CACS, and may be involved in the occurrence and development of coronary artery calcification in MHD patients.