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急性期蛋白作为慢性透析患者腹主动脉钙化的促进因素

Acute-phase proteins as promoters of abdominal aortic calcification in chronic dialysis patients.

作者信息

Avramovski Petar, Avramovska Maja, Sotiroski Kosta, Sikole Aleksandar

机构信息

Department of Chirurgiae, High Medical School; Department of Imaging Diagnostic, Faculty of Veterinary Medicine, University St. Clement of Ohrid University of Bitola; Department of Internal Medicine, Abdominal and Renal Ultrasonography, Bitola, Macedonia.

Department of Obstetrics and Gynecology, Clinical Hospital Dr. Trifun Panovski, Bitola, Macedonia.

出版信息

Saudi J Kidney Dis Transpl. 2019 Mar-Apr;30(2):376-386. doi: 10.4103/1319-2442.256845.

Abstract

The aim of this study was to find a correlation between acute-phase proteins (APPs) and abdominal aortic calcification (AAC) as well as the impact APPs on AAC in chronic dialysis patients (CDPs). Native lateral lumbar radiography and biochemical analysis were performed in 112 CDPs (aged 60.0 ± 5.43 years) to estimate and score AAC and biochemical values of APPs. The mean AAC score was 8.39 ± 5.43. We detected 16 (14.28%) CDPs without AAC and 96 (85.71%) CDPs with AAC (10 ± 5.43). The number of CDPs with AAC ≤4 was 34 (30.36%) with mean AAC score of 1.85 ± 1.94. By multiple regression analysis, we found positive correlation between AAC and ferritin (β = 0.004398, P = 0.0085) and AAC and C-reactive protein [(CRP), β = 0.1972, P = 0.0178]. Sensitivity/specificity pairs and criterion variables (CrVs) were as follows: for CRP: 44.21%, 100%, and CrV ≥6 and for ferritin: 83.16%, 56.25%, and CrV ≥196.32. The area under curve (AUC) for CRP and ferritin was 0.721 (P <0.0001) and 0.730 (P <0.0026), respectively. Fibrinogen and serum iron AUC in the prediction of AAC were 0.533 (P = 0.5749) and 0.618 (P = 0.0795), respectively. CRP and ferritin were the most powerful APPs involved in the promotion of AAC; serum iron and fibrinogen were shown as lower activity promoters in CDPs. Serum albumin showed inverse activity on AAC.

摘要

本研究的目的是探寻慢性透析患者(CDP)体内急性期蛋白(APP)与腹主动脉钙化(AAC)之间的相关性,以及APP对AAC的影响。对112例CDP(年龄60.0±5.43岁)进行了腰椎正侧位X线摄影及生化分析,以评估AAC并对APP的生化值进行评分。平均AAC评分为8.39±5.43。我们检测到16例(14.28%)无AAC的CDP和96例(85.71%)有AAC的CDP(10±5.43)。AAC≤4的CDP有34例(30.36%),平均AAC评分为1.85±1.94。通过多元回归分析,我们发现AAC与铁蛋白之间呈正相关(β=0.004398,P=0.0085),AAC与C反应蛋白[(CRP),β=0.1972,P=0.0178]之间也呈正相关。敏感性/特异性对及标准变量(CrV)如下:对于CRP:44.21%,100%,CrV≥6;对于铁蛋白:83.16%,56.25%,CrV≥196.32。CRP和铁蛋白的曲线下面积(AUC)分别为0.721(P<0.0001)和0.730(P<0.0026)。纤维蛋白原和血清铁在预测AAC中的AUC分别为0.533(P=0.5749)和0.618(P=0.0795)。CRP和铁蛋白是促进AAC的最主要APP;血清铁和纤维蛋白原在CDP中表现为活性较低的促进因子。血清白蛋白对AAC表现出反向活性。

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