血液透析患者血清多腺苷二磷酸核糖聚合酶1水平与血管钙化的相关性研究

张慧; 罗进辉; 杨柳; 童运涛; 蔡红琳

doi:10.3969/j.issn.1671-2390.2023.10.007

血液透析患者血清多腺苷二磷酸核糖聚合酶1水平与血管钙化的相关性研究

Correlation between serum level of PARP1 and vascular calcification in hemodialysis patients

摘要

摘要:
目的探讨血清多腺苷二磷酸核糖聚合酶poly（ADP-ribose） polymerase，PARP1水平与血液透析患者血管钙化的相关性。
方法回顾性分析2020年1月至2021年12月在武汉市汉口医院诊治的168例血液透析患者，根据冠状动脉钙化积分对所有患者血管钙化程度进行评估，分为无钙化组45例、轻度钙化组26例、中度钙化组53例、重度钙化组44例。采用酶联免疫吸附法检测血液透析患者血清PARP1水平；Spearman法分析血液透析患者血清PARP1水平与血管钙化积分的相关性；对血清PARP1与白蛋白（albumin，Alb）、血红蛋白（hemoglobin，Hb）、Ca²⁺、P³⁻、甲状旁腺激素（parathyroid hormone，PTH）水平、超敏C反应蛋白（hypersensitive C-reactive protein，hs-CRP）的相关性进行Pearson法分析；对影响血液透析患者发生血管钙化的因素进行Logistic回归分析；受试者工作特征曲线（receiver operating characteristic curve，ROC）分析血清PARP1水平对血液透析患者发生血管钙化的诊断价值。
结果无钙化组血液透析患者血清PARP1水平为（4.05 ± 1.18）μg/L。与无钙化组相比，轻度、中度、重度钙化组血液透析患者血清PARP1水平均升高（P＜0.05），血管钙化程度越重，PARP1水平、钙化评分越高（P＜0.05）；血液透析患者血清PARP1水平与钙化积分（r=0.662，P＜0.05）、Ca²⁺（r=0.547，P＜0.05）、P³⁻（r=0.421，P＜0.05）、PTH（r=0.652，P＜0.05）、hs-CRP（r=0.640，P＜0.05）水平均呈正相关，与Alb（r=−0.600，P＜0.05）、Hb（r=−0.616，P＜0.05）水平均呈负相关；Logistic回归分析发现，年龄、透析龄、Ca²⁺、P³⁻、PTH、hs-CRP、PARP1是血液透析患者发生血管钙化的危险因素（P＜0.05），Alb、Hb是血液透析患者发生血管钙化的保护因素（P＜0.05）；血清PARP1水平诊断血液透析患者发生血管钙化的ROC曲线下面积为0.936，截断值为4.39 μg/L。
结论血液透析患者血清PARP1水平随着血管钙化程度的加重而升高，可较好的诊断血液透析患者血管钙化。

Abstract:
Objective To explore the correlation between serum level of poly(ADP-ribose) polymerase 1 (PARP1) and vascular calcification in hemodialysis (HD) patients.
Methods From January 2020 to December 2021, 168 hospitalized HD patients were selected for retrospective analysis. According to the degree of vascular calcification as evaluated by coronary artery calcification score, they were assigned into four groups of non-calcification (n=45), mild calcification (n=26), moderate calcification (n=53) and severe calcification (n=44). Enzyme-linked immunosorbent assay (ELISA) was utilized for detecting serum level of PARP1. Spearman’s method was employed for examining the correlation between serum level of PARP1 and vascular calcification score. And the correlation between serum level of PARP1 and the levels of albumin (Alb), hemoglobin (Hb), calcium (Ca²⁺), phosphorus (P³⁻) and parathyroid hormone (PTH) was analyzed by Pearson’s method. Logistic regression analysis was performed for the influencing factors of the occurrence of vascular calcification. Diagnostic value of serum level of PARP1 for vascular calcification was analyzed by receiver operating characteristic (ROC) curve.
Results Serum level of PARP1 without calcification was (4.05±1.18)μg/L. As compared with non-calcification group, serum level of PARP1 was obviously higher in mild/moderate/severe calcification group (P<0.05). The greater degree of vascular calcification, the higher value of PARP1 and calcification score (P<0.05); serum level of PARP1 was correlated positively with calcification score, the levels of Ca²⁺, P³⁻, PTH and hs-CRP (calcification score: r=0.662, P<0.05; Ca²⁺: r=0.547, P<0.05; P³⁻: r=0.421, P<0.05; PTH: r=0.652, P<0.05; hs-CRP: r=0.640, P<0.05) were correlated negatively with the levels of Alb and Hb (Alb: r=−0.600, P<0.05; Hb: r=−0.616, P<0.05); Logistic regression analysis indicated that age, dialysis age, Ca²⁺, P³⁻, PTH, hs-CRP and PARP1 were the risk factors for vascular calcification (P<0.05) while Alb and Hb served as the protective factors for vascular calcification (P<0.05). Area under the ROC curve (AUC) of vascular calcification diagnosed by serum level of PARP1 was 0.936 with a cut-off value of 4.39 μg/L.
Conclusions Serum level of PARP1 rises with worsening vascular calcification. It may better diagnose vascular calcification in HD patients.

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