| Objectives:Cardiovascular disease is the main cause of death in patients with end-stage renal disease,and vascular calcification is the main mechanism for the occurrence of cardio-vascular disease.We traditionally think of high phosphorus and low calcium,secondary hyperparathyroidism and age,dialysis time in patients with chronic kidney disease especially the main factors for CVD in patients with maintenance hemodialysis,and in recent years,some studies found that calcium phosphate metabolism and vascular calcification of soluble Klotho protein,fibroblast growth factor-23 patients with CKD are closely related.Arterial calcification score is an objective index for evaluating arterial calcification,and it can predict the incidence of cardiovascular events[1]well.Early assessment of vascular calcification and early intervention in MHD patients is essential for the prevention and treatment of cardiovascular disease in MHD patients and the improve-ment of the quality of life.The maintenance hemodialysis patients as the research object,to study the relationship between serum sKlotho and MHD protein in patients with abdominal aortic calcification,in order to provide theoretical basis for early prediction of vascular calcification in patients with MHD,which lays the foundation for the early intervention treatment of vascular calcification.Methods:1.cases collected:all the cases are from June 2016 to December 2016 at the Affiliated Hospital of Tai’an Medical College nephrology clinic for regular hemodialysis patients（hemodialysis for more than 6 months）,healthy people selected from the Taishan Medical University Medical Center for health examination,no high blood pressure,diabetes and kidney disease.2.sample collection and detection:all subjects were fasting blood 3ml for 12 hours after fasting.Before the morning dialysis,they were fasting blood for 20 minutes.After2000r/min centrifugation for 20 minutes,the upper serum was stored in the refrigerator at the temperature of-80.The concentration of sKlotho protein and FGF-23 in serum was determined by the competitive method of enzyme linked immunosorbent assay（ELISA）.The general clinical data and biochemical indexes of the patients were collected on the same day.3.Measurement of abdominal aortic calcification:using CT multidetector row computed tomography（MDCT）to evaluate the status of abdominal aortic calcification and calculate the abdominal aortic calcification score.4.group:according to the abdominal aortic calcification score,the patients with vascular calcification in maintenance hemodialysis patients were divided into mild calcification group,moderate calcification group and severe calcification group.5.The data were analyzed using SPSS22.0 software with continuous variables were expressed as standard deviation of measurement data of normal distribution,in line with normal distribution and meet the homogeneity of variance between the two groups were compared using independent samples t test between the three groups;and the above comparison by variance analysis.The classification variables were expressed as percentages,the rate of counting data was described,and the x2 test was used among the groups.Correlation analysis between continuous variables conforming to normal distribution with Person correlation analysis,P<0.05 is statistically significant.Result:1.The maintenance hemodialysis group and the healthy control group were compared with the healthy control group:the hemodialysis patients were 96 cases,including46women and 50 men,with an average age of 59.36±9.25 years old.The age of dialysis:80 cases in the healthy control group,of which 34were female and 46 were male,with an average age of 56.72±6.53years old.After analysis,there was no significant difference in gender and age between the two groups（P>0.05）.The sKL in maintenance hemodialysis group was lower than that in healthy control group（P<0.05）.2.The case group:96 cases of abdominal aortic calcification in maintenance hemodialysis patients,the incidence of abdominal aortic calcification in 86 cases（89.6%）,according to the degree of calcification of the abdominal aorta can be divided into mild calcification group 29 cases（33.7%）,37 cases of moderate calcification group（43% cases）and severe calcification group 20 cases（23.3%）.3.Between the different degree of vascular calcification in MHD patients between the three groups in the general clinical data comparison shows that besides age between the three groups had significant difference（P<0.05）,outside the rest of the general clinical data such as age,gender,dialysis hypertension,diabetes,history of drug taking calcium phosphate binders etc.there was no significant difference in general（P>0.05）,no statistical differences between biochemical indices between the three groups（P>0.05）,there were significant differences between the three groups of sKlotho protein,FGF23（P<0.05）.4.The correlation analysis results shown by the statistical software of serump-hosphorus,calcium,FGF-23,sKlotho protein and AACs:AACs was positively correlated with serum phosphorus（r=0.302,P<0.05）,and serum calcium was positively related（r=0.245,P<0.05）,was positively correlated with FGF-23（r=0.791,P<0.05）,and negatively correlated with sKlotho protein（r=-0.839,P<0.05）.5.The correlation between sKlotho protein and FGF-23,serum phosphorus,calcium,GFR:sKL was negatively correlated with FGF-23（r=-0.876,P<0.05）;negatively correlated with serum phosphorus（r=-0.424,P<0.05）;sKL was positively corr-elated with serum calcium（r=-0.367,P<0.05）;positive correlation with GFR（r=0.834,P<0.05）.Conclusion:Serum sKlotho protein is a protective protein for vascular calcification.It can delay the occurrence and development of abdominal aortic calcification in MHD patients by regulating calcium and phosphorus metabolism.The detection of sKlotho protein concentration in serum is beneficial to the early prediction of vascular calcification,which will provide theoretical support for the early diagnosis and treatment of vascular calcification. |
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