长正五聚蛋白3与慢性肾脏病5期患者桡动脉钙化的相关性研究

Correlation between long pentraxin 3 and radial artery calcification in patients with chronic kidney disease stage 5

目的研究慢性肾脏病(CKD)5期患者的长正五聚蛋白3(PTX3)在桡动脉和外周血中的表达及其与桡动脉钙化的相关性。方法选择2015年12月至2018年10月就诊于哈尔滨医科大学附属第一医院(包括群力分院)行前臂动静脉内瘘成形术的53例CKD 5期患者。通过Von Kossa染色法观察桡动脉钙化情况,根据钙盐沉积情况分为无钙化组(27例)、轻中度钙化组(18例)及重度钙化组(8例)。采用免疫组化法观察桡动脉PTX3与碱性磷酸酶(ALP)表达情况,收集基本资料、临床指标及术前空腹静脉血,采用酶联免疫吸附测定(ELISA)方法检测血浆PTX3水平。比较组间PTX3水平及临床指标差异,将患者桡动脉PTX3表达水平与临床资料行相关性分析。结果与轻中度钙化组及无钙化组比较,重度钙化组的尿酸(UA)、总胆固醇(CHOL)、三酰甘油(TG)、甲状旁腺素(PTH)的表达增加,差异均有统计学意义(均P<0.05);重度钙化组与轻中度钙化组患者桡动脉血管PTX3及ALP的AOD表达均高于无钙化组,差异均有统计学意义(均P<0.001);血液中的UA、CHOL、TG、PTH水平与桡动脉组织PTX3的表达有相关性(均P<0.05);血浆中PTX3表达水平与UA、CHOL、TG、PTH呈正相关(均P<0.05)。结论PTX3在CKD 5期患者外周血与桡动脉上的表达与钙化程度密切相关,可能参与CKD5期患者血管钙化的病理生理过程。

Objective To study the correlation between long pentraxin 3(PTX3)and radial artery calcification in patients with chronic kidney disease stage 5(CKD5 stage),and its expression in radial artery and peripheral blood.Methods From December 2015 to October 2018,53 patients with stage 5 CKD who underwent forearm arteriovenous fistula plasty in the first affiliated hospital of Harbin medical university(including Qunli branch)were selected.The calcification of the radial artery was observed by Von Kossa staining.The samples were grouped according to calcium deposition.For the no calcification group(27 cases),mild to moderate calcification group(18 cases)and severe calcification group(8 cases),the expression of PTX3 and ALP in the radial artery was observed by immunohistochemistry.The basic data,clinical indicators and preoperative fasting venous blood of the patients were collected.The plasma PTX3 level was detected by enzyme-linked immunosorbent assay(ELISA).The differences in PTX3 levels and clinical indicators between the groups were compared,and the correlation between the expression levels of PTX3 in the radial artery of the patients and the clinical data was analyzed.Results The expression of uric acid(UA),total cholesterol(CHOL),triglyceride(TG)and parathyroid hormone(PTH)in severe calcification group was significantly higher than that in mild to moderate calcification group and non calcification group(all P<0.05).The AOD expression of PTX3 and ALP in radial artery vessels in severe calcification group and mild to moderate calcification group were significantly higher than that in non calcification group(all P<0.001).The levels of UA,CHOL,TG and PTH in blood were correlated with the expression of PTX3 in radial artery(all P<0.05).The expression level of PTX3 in peripheral blood was positively correlated with UA,CHOL,TG and PTH(all P<0.05).Conclusions The expression of PTX3 in peripheral blood and radial artery of stage CKD5 patients is closely related to the degree of calcification,which may be involved in the pathophysiological process of vascular calcification in CKD5 patients.