维持性血液透析患者血清富亮氨酸α-2糖蛋白-1水平与动脉粥样硬化程度的相关性分析

    Correlation analysis between serum leucine-rich α2-glycoprotein-1 level and degree of atherosclerosis in maintenance hemodialysis patients

      摘要
    • 摘要:
      目的  探讨血清富亮氨酸α-2糖蛋白-1（leucine-rich α2-glycoprotein-1，LRG1）水平与维持性血液透析患者动脉粥样硬化程度的关系。
      方法  选取2016年1月至2020年1月在秦皇岛市第一医院进行血液透析的160例维持性血液透析患者作为研究对象，收集其一般资料及实验室指标。采用彩色多普勒超声测定患者颈动脉内中膜厚度（intima-media thickness，IMT），并将其分为正常组55例，其中男28例，女27例，年龄（50.26 ± 7.94）岁，年龄范围40～80岁；内膜增厚组58例，其中男30例，女28例，年龄（60.72 ± 8.63）岁，年龄范围41～80岁；斑块组47例，其中男26例，女21例，年龄（70.14 ± 8.28）岁，年龄范围40～80岁。采用酶联免疫吸附法检测患者血清LRG1水平。采用Pearson及Spearman相关性分析维持性血液透析患者IMT与一般资料、实验室指标及血清LRG1的相关性；采用多因素Logistic回归分析维持性血液透析患者动脉粥样硬化的影响因素。
      结果  斑块组LRG1为（83.74 ± 9.94）mg/L，年龄为（70.14 ± 8.28）岁，透析龄为（38.72 ± 6.49）个月，低密度脂蛋白胆固醇（low density lipoprotein-cholesterol，LDL-C）为（2.52 ± 0.61）mmol/L，总胆固醇（total cholesterol，TC）为（4.21 ± 1.02）mmol/L，均显著高于内膜增厚组的（67.95 ± 8.65）mg/L、（60.72 ± 8.63）岁、（33.48 ± 6.50）个月、（1.89 ± 0.59）mmol/L、（3.52 ± 0.78）mmol/L和正常组的（52.46 ± 8.73）mg/L、（50.26 ± 7.94）岁、（29.72 ± 6.78）个月、（1.42 ± 0.62）mmol/L、（2.96 ± 0.81）mmol/L，各组差异均有统计学意义（P＜0.05）。维持性血液透析患者IMT与LRG1、年龄、透析时间、LDL-C、TC均呈正相关（r = 0.534、0.509、0.512、0.492、0.489，P＜0.05）。LRG1、年龄是维持性血液透析患者动脉粥样硬化的独立危险因素（P＜0.05）。
      结论  随着维持性血液透析患者动脉粥样硬化程度增加，血清LRG1水平升高，且LRG1与IMT呈正相关，提示检测血清LRG1水平有助于评估颈动脉粥样硬化程度。

       

      Abstract:
      Objective  To explore the relationship between serum level of leucine-rich α2-glycoprotein-1（LRG1） and the degree of atherosclerosis in maintenance hemodialysis（MHD） patients.
      Methods  From January 2016 to January 2020, 160 MHD patients were selected as research subjects and their general profiles and laboratory parameters recorded. Intima-media thickness（IMT） of carotid artery was measured by color Doppler ultrasonography. They were assigned into three groups of normal（n = 55）, endometrial thickening（n = 58） and plaque（n = 47）. Normal group was composed of 28 males and 27 females with an average age of （50.26 ± 7.94）（40-80） year; Endometrial thickening group had 30 males and 28 females with an average age of （60.72 ± 8.63）（41-80） year; Plaque group included 26 males and 21 females with an average age of （70.14 ± 8.28）（40-80） year. Enzyme-linked immunosorbent assay （ELISA） was utilized for measuring the serum level of LRG1. Pearson/Spearman’s correlation was employed for analyzing the correlation between IMT and general profiles, laboratory parameters and serum level of LRG1; multivariate logistic regression was performed for examining the influencing factors of atherosclerosis in MHD patients.
      Results When comparing plaque, endometrial thickening and normal groups, LRG1 was （83.74 ± 9.94） vs （67.95 ± 8.65） vs （52.46 ± 8.73） mg/L, age （70.14 ± 8.28） vs （60.72 ± 8.63） vs （50.26 ± 7.94） years, dialysis time （38.72 ± 6.49） vs （33.48 ± 6.50） vs （29.72 ± 6.78） month, low-density lipoprotein cholesterol （LDL-C） （2.52 ± 0.61） vs （1.89 ± 0.59） vs （1.42 ± 0.62） mmol/L and total cholesterol（TC） （4.21 ± 1.02） vs （3.52 ± 0.78） vs （2.96 ± 0.81） mmol/L. All were significantly higher in plaque group than those in endometrial thickening and normal groups. And the differences between each group were statistically significant（P＜0.05）. IMT was correlated positively with LRG1, age, dialysis time, LDL-C and TC（r = 0.534, 0.509, 0.512, 0.492, 0.489, P＜0.05）. And LRG1 and age were independent risk factors for atherosclerosis in MHD patients（P＜0.05）.
      Conclusion  With advancing degree of atherosclerosis, serum level of LRG1 rises. And LRG1 is correlated positively with IMT. It implied that detecting serum level of LRG1 aids in evaluating the degree of carotid atherosclerosis in MHD patients.

       

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