老年维持性血液透析患者血清维生素K2与血管钙化的关系
摘要
目的探讨老年维持性血液透析(MHD)患者血清维生素K2与血管钙化的关系及老年MHD患者血管钙化的危险因素。方法选择老年MHD患者90例作为观察组,另选健康体检的志愿者90例作为对照组,比较两组血清维生素K2的水平,分析观察组血清维生素K2水平与其血管钙化的相关性,采用Logistic回归分析筛查老年MHD患者血管钙化的危险因素。结果观察组血清维生素K2水平为(2.47±0.94)nmol/L,明显低于对照组的(4.18±1.05)nmol/L(P<0.05)。根据血管钙化程度将观察组患者再分组,钙化组患者的血清维生素K2水平均明显低于无钙化组,重度钙化组患者的血清维生素K2水平明显低于轻度钙化及中度钙化组患者(P<0.05)。Spearman相关性分析结果表明,观察组血清维生素K2水平与其血管钙化呈现明显的负相关(r=-0.401,P<0.05)。单因素分析显示,血管钙化与糖尿病、血磷、血钙及血清维生素K2水平等因素有关(P<0.05)。经Logistic回归分析发现,患有糖尿病、血磷异常、血钙异常及血清维生素K2异常均是MHD患者血管钙化的危险因素(P<0.05)。结论老年MHD患者血清维生素K2水平与其血管钙化呈现明显的负相关,患有糖尿病、血磷异常、血钙异常及血清维生素K2异常均是老年MHD患者血管钙化的危险因素。
引文
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6 Vanitha RN,Kavimani S,Soundararajan P,et al.Ghrelin and its association with nutritional and inflammatory status of patients on maintenance hemodialysis in a south indian tertiary care hospital[J].Ann Med Health Sci Res,2016;6(3):146-55.
7 钟建,唐农,史伟,等.温阳通络泄浊方对维持性血液透析患者血管钙化的影响[J].中医杂志,2016;57(7):588-91.
8 CaluwéR,Pyfferoen L,De Boeck K,et al.The effects of vitamin K supplementation and vitamin K antagonists on progression of vascular calcifi- cation:ongoing randomized controlled trials[J].Clin Kidney J,2016;9(2):273-9.
9 文杨,夏运风,甘华,等.维持性血液透析患者血管钙化防治[J].中国血液净化,2016;15(5):263-5.
10 Maresz K.Proper calcium use:vitamin K2 as a promoter of bone and cardiovascular health[J].Integr Med(Encinitas),2015;14(1):34-9.
11 Feng Y,Ruan Y,He Q,et al.Suboptimal vitamin K status and its risk factors in a population of Chinese chronic haemodialysis patients[J].Nephrology(Carlton),2015;20(9):625-31.
12 Zaragatski E,Grommes J,Schurgers LJ,et al.Vitamin K antagonism aggravates chronic kidney disease-induced neointimal hyperplasia and calcification in arterialized veins:role of vitamin K treatment[J]?Kidney Int,2016;89(3):601-11.
13 Kurnatowska I,Grzelak P,Masajtis-Zagajewska A,et al.Effect of vitamin K2 on progression of atherosclerosis and vascular calcification in nondialyzed patients with chronic kidney disease stages 3-5[J].Pol Arch Med Wewn,2015;125(9):631-40.
14 El Asmar MS,Naoum JJ,Arbid EJ.Vitamin K dependent proteins and the role of vitamin K2 in the modulation of vascular calcification:a review[J].Oman Med J,2014;29(3):172-7.
2 蒲蕾,吴姝焜,邹杨,等.老年维持性血液透析患者死亡原因分析[J].中华老年医学杂志,2015;34(7):767-70.
3 Qureshi R,Dhrolia MF,Nasir K,et al.Comparison of total direct cost of conventional single use and mechanical reuse of dialyzers in patients of end-stage renal disease on maintenance hemodialysis:A single center study[J].Saudi J Kidney Dis Transpl,2016;27(4):774-80.
4 Toida T,Sato Y,Nakagawa H,et al.Risk of cerebral infarction in japanese hemodialysis patients:miyazaki dialysis cohort study(MID study)[J].Kidney Blood Press Res,2016;41(4):471-8.
5 周树录,王红蕾,王晓红,等.伴多关节异位钙化的维持性血液透析患者一例并文献复习[J].中华临床医师杂志(电子版),2015;9(17):3310-1.
6 Vanitha RN,Kavimani S,Soundararajan P,et al.Ghrelin and its association with nutritional and inflammatory status of patients on maintenance hemodialysis in a south indian tertiary care hospital[J].Ann Med Health Sci Res,2016;6(3):146-55.
7 钟建,唐农,史伟,等.温阳通络泄浊方对维持性血液透析患者血管钙化的影响[J].中医杂志,2016;57(7):588-91.
8 CaluwéR,Pyfferoen L,De Boeck K,et al.The effects of vitamin K supplementation and vitamin K antagonists on progression of vascular calcifi- cation:ongoing randomized controlled trials[J].Clin Kidney J,2016;9(2):273-9.
9 文杨,夏运风,甘华,等.维持性血液透析患者血管钙化防治[J].中国血液净化,2016;15(5):263-5.
10 Maresz K.Proper calcium use:vitamin K2 as a promoter of bone and cardiovascular health[J].Integr Med(Encinitas),2015;14(1):34-9.
11 Feng Y,Ruan Y,He Q,et al.Suboptimal vitamin K status and its risk factors in a population of Chinese chronic haemodialysis patients[J].Nephrology(Carlton),2015;20(9):625-31.
12 Zaragatski E,Grommes J,Schurgers LJ,et al.Vitamin K antagonism aggravates chronic kidney disease-induced neointimal hyperplasia and calcification in arterialized veins:role of vitamin K treatment[J]?Kidney Int,2016;89(3):601-11.
13 Kurnatowska I,Grzelak P,Masajtis-Zagajewska A,et al.Effect of vitamin K2 on progression of atherosclerosis and vascular calcification in nondialyzed patients with chronic kidney disease stages 3-5[J].Pol Arch Med Wewn,2015;125(9):631-40.
14 El Asmar MS,Naoum JJ,Arbid EJ.Vitamin K dependent proteins and the role of vitamin K2 in the modulation of vascular calcification:a review[J].Oman Med J,2014;29(3):172-7.