Objective: To explore the association of NOD-like receptor protein 3(NLRP3), serum creatinine(Scr), hemoglobin(Hb), and interleukin-37(IL-37) with vascular calcification in peritoneal dialysis patients and their predictive value for prognosis. Methods: A total of 116 peritoneal dialysis patients treated from March 2022 to March 2023 were included in this study. 56 patients with vascular calcification were included in the vascular calcification group, and the other 60 patients were included in the non-vascular calcification group. The levels of serum NLRP3, Scr, Hb, and IL-37 in patients were detected, and the differences between the groups were analyzed to explore the relationship between each index and the degree of vascular calcification and prognosis of patients. Results: Patients in the vascular calcification group had higher levels of NLRP3, Scr, Hb, and IL-37 compared to those in the non-calcification group(P<0.001). Compared to patients with mild vascular calcification, those with moderate to severe calcification showed increased levels of NLRP3, Scr, Hb, and IL-37(P<0.05). Patients in the death group exhibited significantly higher levels of NLRP3, Scr, Hb, and IL-37 compared to the survival group(P<0.05). Logistic regression analysis showed that albumin, vascular calcification score, NLRP3, Scr, and IL-37 all had an impact on the death of patients, and had a relatively high predictive efficiency, and these factors showed high predictive efficiency for mortality with area under receiver operating characteristic curve(AUC) values of 0.839, 0.806, 0.766, 0.859 and 0.803, respectively. Conclusion: In peritoneal dialysis patients,serum levels of NLRP3, Scr, Hb, and IL-37 are significantly associated with vascular calcification and significantly impact the risk of mortality. These biomarkers have high predictive efficiency and can serve as effective tools for assessing the risk of vascular calcification and prognosis in peritoneal dialysis patients. |
[1] 付水鸽,袁小强,夏璇.腹膜透析与血液透析治疗老年终末期肾病的疗效分析[J].临床研究,2024,32(5):45-48.
[2] 陈惠霞,王玮玮,党珊,等.血清HO-1、HIF-1 α及FGF23对腹膜透析患者血管钙化的影响[J].中国血液净化,2023,22(8):574-578.
[3] 莫怡浩,王丽,胡明亮,等.尿毒症维持性血液透析患者外周血NLRP3、IL-1β、IL-18水平与血管钙化的相关性分析[J].中国中西医结合肾病杂志,2023,24(5):398-400.
[4] 曹珊,陈清萍,刘玉.腹膜透析患者血管钙化和感染与维生素D受体基因多态性的关联性[J].中华医院感染学杂志,2021,31(11):1644-1649.
[5] CHI X G,MA Z,ZHANG W B,et al.Effects of high-flux hemodialysis combined with levocarnitine on vascular calcification,microinflammation,hepcidin,and malnutrition of elderly patients on maintenance hemodialysis[J].Ann Palliat Med,2021,10(3):3286-3298.
[6] ZHOU P,LI Q,SU S,et al.Interleukin 37 Suppresses M1 macrophage polarization through inhibition of the Notch1 and nuclear factor kappa B pathways[J].Front Cell Dev Biol,2020(3):56.
[7] 张慧,罗进辉,杨柳,等.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[J].临床肾脏病杂志,2023,23(10):835-840.
[8] 梁焯辉,赵凡,刘倩雯.巨噬细胞移动抑制因子与老年2型糖尿病患者颈动脉血管钙化的关系[J].检验医学,2023,38(5):460-465.
[9] WANG X R,YUAN L,SHI R,et al.Predictors of coronary artery calcification and its association with cardiovascular events in patients with chronic kidney disease[J].Ren Fail,2021,43(1):1172-1179.
[10] 李佳,李楠,李庆超,等.慢性肾脏病5期维持性血液透析患者外周血生长激素促分泌素、NOD样受体蛋白3水平与血管钙化的相关性[J].中国临床医生杂志,2022,50(10):1154-1158.
[11] PANG Q,WANG P,PAN Y,et al.Irisin protects against vascular calcification by activating autophagy and inhibiting NLRP3-mediated vascular smooth muscle cell pyroptosis in chronic kidney disease[J].Cell Death Dis,2022,13(3):283.
[12] 喻亚萍,郝丽荣.维持性血液透析患者血清PTX3与血管钙化的相关性[J].临床与病理杂志,2022,42(6):1335-1341.
[13] 侯睿,胡炜,董佩,等.糖尿病肾病患者血清ICAM-1 VCAM-1及CTRP9表达水平与冠脉血管钙化的关系[J].河北医学,2022,28(8):1279-1285.
[14] XIAO Q,TANG Y,LUO H,et al.Sclerostin is involved in osteogenic transdifferentiation of vascular smooth muscle cells in chronic kidney disease-associated vascular calcification with non-canonical Wnt signaling[J].Ren Fail,2022,44(1):1426-1442.
[15] 张华燕,姜聪娇,何援军.终末期肾病患者外周血NOD样受体蛋白水平与血管钙化的相关性研究[J].中国药物与临床,2022,22(6):502-507.
[16] BÖHM E W,PAVLAKI M,CHALIKIAS G,et al.Colocalization of erythrocytes and vascular calcification in human atherosclerosis:a systematic histomorphometric analysis[J].TH Open,2021,5(2):e113-e124.
[17] 柴萌,张海涛,杨丽霞,等.血浆白介素-37水平与糖尿病患者冠状动脉钙化程度的相关性分析[J].心肺血管病杂志,2021,40(12):1211-1214.
[18] 李慧敏,杨超.白细胞介素-37在心血管疾病中的作用及其分子机制的研究进展[J].医学综述,2020,26(19):3780-3784.
[19] 于平,邹春波.微炎症与维持性血液透析患者主动脉弓钙化的相关性研究[J].大连医科大学学报,2022,44(3):218-223. |