维持性血液透析患者血清sICAM-1、 sVCAM-1水平和SOD活性及其与冠状动脉钙化的关系

Levels of sICAM-1 and sVCAM-1 and activity of SOD in serum and their relationships with coronary artery calcification in patients with maintenance hemodialysis

摘要

目的 分析维持性血液透析（MHD）患者血清可溶性细胞间黏附分子1（sICAM-1）和可溶性血管细胞黏附分子1（sVCAM-1）水平及超氧化物歧化酶（SOD）活性，探讨其与冠状动脉钙化（CAC）的关系。 方法 回顾性分析 102 例MHD患者（MHD组）的临床资料，另招募同期接受健康体检的 74 名志愿者（健康体检组）。MHD 组患者经多层螺旋 CT（MSCT）检查行 CAC 分数（CACs）评定，并将其分为无钙化组、轻度钙化组、中度钙化组和重度钙化组。比较2组研究对象一般资料和血清sICAM-1、sVCAM-1水平及SOD活性，分析不同钙化程度组患者血清中钙（Ca）、磷（P）、甲状旁腺激素（PTH）、sICAM-1和sVCAM-1水平及SOD活性。采用Pearson相关分析法分析MHD患者血清sICAM-1和sVCAM-1水平及SOD活性与CACs的相关性。 结果 与健康体检组比较，MHD组患者血清sICAM-1和sVCAM-1水平均明显升高（P<0.01），SOD活性明显降低（P<0.01）。与无钙化组比较，轻度、中度和重度钙化组患者血清PTH、sICAM-1和sVCAM-1水平均明显升高（P<0.05），SOD活性均明显降低（P<0.05）；中度和重度钙化组患者血清P水平均明显升高（P<0.05）。与轻度钙化组比较，中度和重度钙化组患者血清P、PTH、sICAM-1和sVCAM-1水平均明显升高（P<0.05），SOD活性均明显降低（P<0.05）。与中度钙化组比较，重度钙化组患者血清sICAM-1、sVCAM-1和P水平均明显升高（P<0.05），SOD活性明显降低（P<0.05）。MHD患者血清SOD活性与CACs呈负相关关系（r＝－0.484，P<0.01），sICAM-1和sVCAM-1水平与CACs呈正相关关系（r＝0.441，P<0.01；r＝0.561，P<0.01）。 结论 MHD患者血清sICAM-1和sVCAM-1水平及SOD活性异常，并且随着SOD活性降低和sICAM-1及sVCAM-1水平升高，MHD患者的CAC程度加重。

Abstract

Objective To analyze the levels of serum soluble intercellular adhesion molecule-1 （sICAM-1）， soluble vascular cell adhesion molecule-1 （sVCAM-1）， and superoxide dismutase （SOD） activity in the patients with maintenance hemodialysis （MHD）， and to discuss their relationships with coronary artery calcification （CAC）. Methods The clinical materials from 102 MHD patients （MHD group） were retrospectively analyzed. Additionally， 74 volunteers underwent routine health examination at the same time （health examination group） were selected. The CAC scores （CACs） of the patients in MHD group were detected by multi-slice computed tomography （MSCT）， and the patients were categorized into non-calcification group， mild calcification group， moderate calcification group， and severe calcification group. The general data and serum levels of sICAM-1， sVCAM-1， and SOD activities of the subjects in two groups were compared. The levels of calcium （Ca）， phosphorus （P）， parathyroid hormone （PTH）， sICAM-1， sVCAM-1， and SOD activities in serum of the patients with different degrees of calcification were analyzed. Pearson’s correlation analysis was used to analyze the correlations between the levels of sICAM-1， sVCAM-1， and SOD activity in serum of the MHD patients and CACs. Results Compared with health examination group， the levels of sICAM-1 and sVCAM-1 in serum of the patients in MHD group were significantly increased （P<0.01）， and the SOD activity was significantly decreased （P<0.01）. Compared with non-calcification group， the levels of PTH， sICAM-1， and sVCAM-1 in serum of the MHD patients in mild， moderate， and severe calcification groups were significantly increased （P<0.05）， and the SOD activities were significantly decreased （P<0.05）； the levels of P in serum of the MHD patients in moderate and severe calcification groups were significantly increased （P<0.05）. Compared with mild calcification group， the levels of P， PTH， sICAM-1， and sVCAM-1 in serum of the MHD patients in moderate and severe calcification groups were significantly increased （P<0.05）， and the SOD activities significantly decreased （P<0.05）. Compared with moderate calcification group， the levels of sICAM-1， sVCAM-1， and P in serum of the MHD patients in severe calcification group were significantly increased （P<0.05）， and the SOD activity was significantly decreased （P<0.05）. The SOD activity in serum of the MHD patients was negatively correlated with CACs （r =-0.484， P<0.01）， while the levels of sICAM-1 and sVCAM-1 were positively correlated with CACs （r =0.441， P<0.01； r = 0.561， P<0.01）. Conclusion The levels of sICAM-1 and sVCAM-1 and activity of SOD in serum of the MHD patients are abnormal. With the decreasing of the SOD activity and increasing of the levels of sICAM-1 and sVCAM-1， the degree of CAC in the MHD patients is aggravated.

关键词

维持性血液透析 / 超氧化物歧化酶 / 可溶性细胞间黏附分子1 / 可溶性血管细胞黏附分子1 / 冠状动脉钙化

Key words

Maintenance hemodialysis / Superoxide dismutase / Soluble intercellular adhesion molecule-1 / Soluble vascular cell adhesion molecule-1 / Coronary artery calcification

Author summay

康宇薇（2000-），女，四川省广元市人，在读硕士研究生，主要从事肾脏病学基础与临床方面的研究。