| Objective: 1.To study whether there is a difference in serum galectin-3 concentration between peritoneal dialysis patients and healthy people;2.Correlation between serum galectin-3 and heart valve calcification,aortic arch calcification,and bone metabolism markers in peritoneal dialysis patients 3.Calcification of heart valves and aortic arch calcification in peritoneal dialysis patients,influencing factors,and correlation with bone metabolism markers.Methods : A total of 40 patients who underwent continuous ambulatory peritoneal dialysis at the Nephrology Peritoneal Dialysis Center of the Affiliated Hospital of Inner Mongolia Medical University from June 2019 to December 2019 were collected to collect serum and clinical data;the physical examination center of the Affiliated Hospital of Inner Mongolia Medical University Forty healthy patients received serum.After 8 hours of fasting,the test subject should draw 5ml of anterior cubital venous blood in the early morning awake state,avoid any cell stimulation during the operation.After collecting the blood,set the centrifuge speed to 3000 rpm and centrifuge the serum for 20 minutes.It was quickly and carefully separated from red blood cells.The separated serum was aliquoted into a 1.5 ml EP tube and stored frozen in a-80 ° C refrigerator.The enzyme-linked immunosorbent assay(ELISA)double antibody sandwich method was used to determine the serum galectin-3 concentration.Patients undergoing peritoneal dialysis underwent echocardiography and detected one or more strong echoes greater than 1 mm in the aortic valve,mitral valve or annulus.An experienced echocardiographer performed an echocardiogram.Chest radiographs were performed on patients with peritoneal dialysis.Aortic arch calcification has 4 levels: no visible calcification at level 0;small spot calcification or a small thin calcification area at level 1;1 or more thickness calcification areas at level 2 Grade 3 is ring-shaped calcification,which is scored by an experienced radiologist.Measurement data that conforms to the normal distribution is expressed X ± S,and t-tests are used for comparison between groups;non-normally distributed measurement data are expressed as median or interquartile range,and comparisons between groups are performed using the Mann-Whitney rank sum test;counts The data are expressed by the number of cases and percentages.Chi-square test is used for comparison between groups.Pearson correlation analysis is used to determine whether there is a linear correlation between serum galectin-3 and bone metabolism markers.The spearman rank correlation analysis method was used to compare the correlation between serum galectin-3,bone metabolism markers and heart valve calcification and aortic arch calcification.P <0.05 indicated that the difference was statistically significant.Results:(1)The serum galectin-3 concentration of the 40 selected patients with peritoneal dialysis was 11.36 ± 3.18 ng / ml,and the serum galectin-3 concentration of the 40 selected patients was 7.01 ± 2.26 ng / ml.The serum galectin-3 concentration was higher in patients than in healthy subjects.(2)In patients with peritoneal dialysis,serum galectin-3 had no correlation with whether the heart valves were calcified and the degree of aortic arch calcification,and the difference was not statistically significant.Among them,19 cases of peritoneal dialysis patients were tested for bone metabolism markers,galectin-3 The concentration was 11.95 ± 3.23 ng / ml,serum galectin-3 and VD3 showed a significant negative correlation,the difference was statistically significant(P <0.05),and osteocalcin,type 1 collagen aminopeptide,β-There was no correlation between collagen degradation products and the difference was not statistically significant.(3)Among the patients with peritoneal dialysis,there were 28 cases of aortic arch calcification,accounting for 70%,and the incidence of aortic arch calcification was high.Among the patients of peritoneal dialysis,16 cases of heart valve calcification,accounting for 40%,including aortic valve calcification.For simple mitral valve calcification.(4)The dialysis age of the heart valve calcification group was longer than that of the heart valve non-calcification group,and the difference was statistically significant(P <0.05);there was a significant difference in fasting blood glucose between the heart valve calcification group and the heart valve non-calcification group,5.35(4.23,8.03)mmol / L VS 4.52(4.10,5.28)mmol / L.(5)Patients in the aortic arch calcification group were older than those in the aortic arch calcification group,with a significant statistical difference(P <0.01),58.29 ± 12.22 years old vs 40 ± 13.64 years old;the triglycerides in the aortic arch calcification group were higher than those in the aortic arch calcification group.There was statistical significance(P <0.05),1.50 ±0.75 mmol / L VS 0.90 ± 0.65 mmol / L.(6)Fasting blood glucose,age of dialysis and heart valve calcification were significantly positively correlated,and urine output was significantly negatively correlated with heart valve calcification;triglyceride,age,dialysis age and aortic arch calcification were significantly positively correlated,high-density There was a significant negative correlation between protein and albumin and the degree of aortic arch calcification.(7)Taking peritoneal dialysis patients as heart valve calcification,aortic arch calcification as dependent variables,all clinical indicators and laboratory indicators as independent variables,the chi square test was applied,and the heart valve calcification group compared with age,P = 0.021,the difference was statistically significant The heart valve calcification group had a higher age ratio than the heart valve calcification group,0.56 Vs 0.21;compared with the dialysis age,P = 0.038,the difference was statistically significant.The heart valve calcification group had a higher dialysis age rate than the heart valve calcification group.0.75 Vs 0.42.Compared with the age of the aortic arch calcification group,P = 0.049,the difference is statistically significant.The incidence of aortic arch calcification in patients aged ≤60 years is lower than that of aortic arch calcification in patients> 60 years old.0.58 VS 0.93;= 0.021,the difference is statistically significant.The rate of oral phosphorus-lowering drugs in the aortic arch calcification group was lower than the rate of oral phosphorus-lowering drugs in the aortic arch calcification group 0.11 VS 0.5.(8)The included 19 peritoneal dialysis patients were tested for bone metabolism markers.Whether the heart valve calcification and aortic arch calcification were not related to bone metabolism markers(osteocalcin,VD3,type 1 collagen aminopeptide,β-collagen degradation products)The difference is not statistically significant.Conclusions:1.Serum galectin-3 levels are higher in patients with peritoneal dialysis than in healthy subjects.2.There is no correlation between serum galectin-3 and heart valve calcification and aortic arch calcification in patients with peritoneal dialysis;serum galectin-3 has a significant negative correlation with VD3,and it is related to osteocalcin,type 1collagen amino propeptide,There was no correlation between β-collagen degradation products.3.The incidence of heart valve calcification and aortic arch calcification is high in patients with peritoneal dialysis.The incidence of calcification of aortic valve alone is higher than that of mitral valve calcification alone.4.Old age,high dialysis phosphorus,increased fasting blood glucose,and increased triglyceride are risk factors for cardiovascular calcification in patients with peritoneal dialysis.Residual urine volume,oral non-calcium phosphate-reducing drugs(sevelamer),serum white Protein and HDL are protective factors for cardiovascular calcification in patients with peritoneal dialysis.5.Heart valve calcification,aortic arch calcification,and bone metabolism markers(osteocalcin,VD3,type 1 collagen amino propeptide,β-collagen degradation products)were not related in patients with peritoneal dialysis. |
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