血清锌-α2-糖蛋白、骨硬化蛋白、胎球蛋白A水平与维持性血液透析患者冠状动脉钙化的关系及其诊断价值研究

Relationship between Serum Zinc-α2-Glycoprotein,Osteosclerotic Protein,Fetal Globulin A Levels and Coronary Artery Calcification in Patients Undergoing Maintenance Hemodialysis and its Diagnostic Value Study

目的:研究血清锌-α2-糖蛋白(ZAG)、骨硬化蛋白(SOST)及胎球蛋白A(FA)水平与维持性血液透析(MHD)患者冠状动脉钙化的关系及其诊断价值。方法:将2018年1月~2021年4月于我院接受MHD的203例患者纳入研究。将其按照冠状动脉钙化积分分作钙化组133例以及无钙化组70例。分析两组各项基线资料以及实验室指标水平的差异,并以多因素Logistic回归分析明确MHD患者冠状动脉钙化的影响因素。另外,通过受试者工作特征(ROC)曲线分析明确血清ZAG、SOST及FA诊断MHD患者冠状动脉钙化的效能。结果:钙化组年龄及血磷、SOST水平均高于无钙化组,而血清ZAG、FA水平均低于无钙化组(P<0.05)。经多因素Logistic回归分析可得:年龄、血磷以及血清SOST、ZAG、FA均是MHD患者冠状动脉钙化的影响因素(P<0.05)。经ROC曲线分析发现:血清ZAG、SOST及FA联合诊断MHD患者冠状动脉钙化的曲线下面积、灵敏度、特异度以及约登指数均高于上述三项指标单独诊断。结论:血清ZAG、SOST及FA均和MHD患者冠状动脉钙化密切相关,可作为辅助诊断MHD患者冠状动脉钙化的生物学标志物。

Objective:To study the relationship between serum zinc-α2-glycoprotein(ZAG),sclerostin(SOST)and fetal globulin A(FA)levels and coronary artery calcification in patients with maintenance hemodialysis(MHD)and its diagnostic value.Methods:A total of 203 patients receiving MHD in hospital from January 2018 to April 2021 were included in this study.According to the difference of coronary artery calcification score,the patients were divided into calcification group with 133 cases and non-calcification group with 70 cases.The differences in baseline data and laboratory indicators levels between the two groups were analyzed,and multivariate Logistic regression analysis was performed to determine the influencing factors of coronary artery calcification in patients with MHD.In addition,the efficacy of serum ZAG,SOST and FA in the diagnosis of coronary artery calcification in patients with MHD was determined by receiver operating characteristic(ROC)curve analysis.Results:Age,serum phosphorus and SOST levels in calcification group were higher than those in non-calcification group,while serum ZAG and FA levels were lower than those in non-calcification group(P<0.05).Multivariate Logistic regression analysis showed that age,serum phosphorus and serum SOST,ZAG and FA were influence factors for coronary artery calcification in patients with MHD(P<0.05).The ROC curve analysis showed that the area under the curve,sensitivity,specificity and Youden index of serum ZAG,SOST and FA in the combined diagnosis of coronary artery calcification in patients with MHD were higher than those of the above three indicators alone.Conclusion:Serum ZAG,SOST and FA are closely related to coronary artery calcification in patients with MHD,and may be used as possible biomarkers to assist in the diagnosis of coronary artery calcification in patients with MHD.