天津医药

天津医药 ›› 2022, Vol. 50 ›› Issue (5): 513-517.doi: 10.11958/20212280

• 临床研究 • 上一篇    下一篇

Ⅲ~Ⅴ期非透析治疗的慢性肾脏病患者血清VK2、Runx2的表达及其与心血管钙化的关系

符薇薇1，陈洁1，巫琼微1，罗江宾2，李周扬3，龙作鹏1   

  1. 1四川大学华西三亚医院肾内科（邮编572000），2心血管内科，3检验科
  • 收稿日期:2021-10-11 修回日期:2021-12-20 出版日期:2022-05-15 发布日期:2022-07-04

Serum levels of VK2 and Runx2 and their relationship with cardiovascular calcification in patients with stage Ⅲ-Ⅴ non dialysis chronic kidney disease

FU Weiwei1, CHEN Jie1, WU Qiongwei1, LUO Jiangbin2, LI Zhouyang3, LONG Zuopeng1   

  1. 1 Department of Nephrology, 2 Department of Cardiology, 3 Department of Laboratory, West China (Sanya) Hospital, 
    Sichuan University, Sanya 572000, China
  • Received:2021-10-11 Revised:2021-12-20 Published:2022-05-15 Online:2022-07-04

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摘要： 目的　探讨Ⅲ~Ⅴ期非透析治疗的慢性肾脏病（CKD）患者血清维生素K2（VK2）、Runt相关转录因子2（Runx2）的表达及其与心血管钙化的关系。方法　选取Ⅲ~Ⅴ期非透析治疗CKD患者149例，根据临床分期将其分为Ⅲ期组（58例）、Ⅳ期组（52例）和Ⅴ期组（39例）。另根据患者的心血管钙化情况将其分为钙化组（42例）和无钙化组（107例）。收集所有患者的一般资料，采用全自动生化分析仪检测血磷、钙、肌酐（Cr）、胱抑素C（Cys C）的水平，采用酶联免疫吸附试验检测血清VK2、Runx2的表达。结果　Ⅲ期组、Ⅳ期组和Ⅴ期组的磷、Cr、Cys C、Runx2水平以及心血管钙化率均逐渐升高，钙、VK2水平均逐渐降低（P＜0.05）。钙化组的磷、Cys C、Runx2水平高于无钙化组，VK2水平低于无钙化组（P＜0.05）。多因素分析显示，磷、Runx2高表达是CKD患者合并心血管钙化的危险因素，而VK2高表达是CKD患者合并心血管钙化的保护因素（P＜0.05）。ROC分析显示，血清VK2、Runx2和磷对CKD患者合并心血管钙化有较高的评估价值，曲线下面积分别为0.843（95%CI：0.773～0.913）、0.819（95%CI：0.749～0.889）、0.797（95%CI：0.726～0.868）。结论　Ⅲ~Ⅴ期非透析治疗的CKD患者血清VK2水平随着分期的增加而降低，Runx2水平随着分期的增加而增加，两者均与患者的心血管钙化情况密切相关。

关键词: 血管钙化, 维生素K2, 慢性肾脏病, Runt相关转录因子2

Abstract: Objective　To investigate the serum expression levels of vitamin K2 (VK2), runt related transcription factor 2 (Runx2) and their relationship with cardiovascular calcification in patients with stage Ⅲ-Ⅴ non dialysis chronic kidney disease (CKD). Methods　A total of 149 patients with stage Ⅲ-Ⅴ CKD who did not receive dialysis were selected. According to the clinical stage, patients were divided into the stage Ⅲ group (58 cases), the stage Ⅳ group (52 cases) and the stage Ⅴ group (39 cases). In addition, according to the cardiovascular calcification, the patients were divided into the calcification group (42 cases) and the non calcification group (107 cases). The general data of all patients were collected. Serum levels of phosphorus, calcium, creatinine (Cr) and cystatin C (Cys C) were detected by automatic biochemical analyzer. The serum expressions of VK2 and Runx2 were detected by enzyme-linked immunosorbent assay kit. Results　The levels of phosphorus, Cr, Cys C, Runx2 and cardiovascular calcification rate were increased gradually in the stage Ⅲ group, the stage Ⅳ group and the stage Ⅴ group, and levels of calcium and VK2 were decreased gradually, and the difference was statistically significant between groups (P＜0.05). The levels of phosphorus, Cys C and Runx2 were higher in the calcified group than those in the non calcified group, and the level of VK2 was lower than that in the non calcified group (P＜0.05). Multivariate analysis showed that the high expression levels of phosphorus and Runx2 were the risk factors of cardiovascular calcification in patients with CKD, while the high expression of VK2 was the protective factor of cardiovascular calcification in patients with CKD (P＜0.05). ROC analysis showed that serum levels of VK2, Runx2 and phosphorus had high evaluation value for patients with CKD complicated with cardiovascular calcification, and the areas under the curve were 0.843 (95%CI: 0.773-0.913), 0.819 (95%CI: 0.749-0.889) and 0.797 (95%CI: 0.726-0.868) respectively. Conclusion　The serum level of VK2 is decreased with the increase of stage, and the level of Runx2 is increased with the increase of stage in patients with stage Ⅲ-Ⅴ non dialysis CKD. Both VK2 and Runx2 are closely related to the situation of cardiovascular calcification.

Key words: vascular calcification, vitamin K2, chronic kidney disease, Runt-related transcription factor 2

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