贵州医科大学学报

2019, v.44;No.222(03) 350-355

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终末期肾病患者血清Klotho蛋白水平与心血管疾病发生的关系
Relation between Serum Klotho Protein Level and Cardiovascular Disease in Patients with End-stage Nephropathy

郭莉;李建东;郭珊珊;李晶;龚幼兰;陈航;
GUO Li;LI Jiandong;GUO Shanshan;LI Jing;GONG Youlan;CHEN Hang;Department of Nephrology,the Affiliated Hospital of Hebei University;

摘要(Abstract):

目的:探讨终末期肾病(ESRD)患者血清Klotho蛋白与心血管疾病(CVD)的关系,分析Klotho蛋白对ESRD患者预后的影响。方法:收集50例接受规律血液透析> 3个月及50例腹膜透析> 3个月ESRD患者的临床资料,采用ELISA法检测患者每月血液透析或腹膜透析前血清Klotho蛋白水平,根据Klotho四分位数将患者分为Ⅰ组(Klotho Objective: To investigate the relation of serum Klotho protein with cardiovascular disease( CVD) in patients with end-stage nephropathy( ESRD) and to analyze the effect of Klotho protein on the prognosis of ESRD patients. Methods: Clinical data of 50 ESRD patients receiving regular hemodialysis for over 3 months and 50 ESRDpatients receiving peritoneal dialysis for over 3 monthswere collected,serum Klotho protein levels before hemodialysis or peritoneal dialysis were detected by ELISA.ESRD patients were categorized into four groups according to the quartiles of Klotho: groupⅠ( Klotho <358. 67 ng/L),groupⅡ( 358. 67 ng/L≤Klotho < 412. 46 ng/L),groupⅢ( 412. 46 ng/L≤Klotho <461. 51 ng/L),groupⅣ( Klotho≥461. 51 ng/L). The occurrence time of nonfatal CVD and all-cause mortality were recorded during the 24 months follow-up. Multivariate binary Logistic regression analysis was used to test the correlation between Klotho protein and nonfatal CVD events. Results: All 100 ESRD patients had serum Klotho protein concentration ranging from 310. 17 ng/L to 567. 68 ng/L.And 59 patients suffered from nonfatal CVD with 143 cases during the follow-up period. Low Klotho was the risk factors of coronary artery disease( OR = 0. 997,P = 0. 018) and peripheral artery occlusion( OR = 0. 997,P = 0. 047). The higher age was a risk factor for all newly developed non-fatal CVD in ESRD patients( OR = 1. 093,1. 076,1. 258,1. 099,P < 0. 05),and long-term dialysis was a risk factor for coronary artery disease( OR = 1. 003,P = 0. 011) and cerebrovascular accident( OR =1. 103,P = 0. 011). There were a total of 17 deaths of 100 ESRD patients,all-cause mortality and CVD mortality of the 4 groups were compared and the differences were statistically significant( P <0. 05). All-cause mortality in patients with ESRD of the group I,Ⅱ was significantly higher than that of groupⅣ( P < 0. 01). Conclusion: Low Klotho protein level is a risk factor for coronary artery disease and peripheral artery occlusion in ESRD patients. The lower the Klotho protein level is,the higher the mortality of ESRD patients will be.

关键词(KeyWords): Klotho蛋白;心血管疾病;终末期肾病;死亡率;透析;血管钙化;钙磷代谢
Klotho protein;cardiovascular disease;end-stage renal disease;mortality;dialysis;vascular calcification;calcium and phosphorus metabolism

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基金项目(Foundation): 河北省科技计划项目(162777230)

作者(Author): 郭莉;李建东;郭珊珊;李晶;龚幼兰;陈航;
GUO Li;LI Jiandong;GUO Shanshan;LI Jing;GONG Youlan;CHEN Hang;Department of Nephrology,the Affiliated Hospital of Hebei University;

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