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目的 探讨腹膜透析患者血清跨膜受体蛋白(Notch1)、含半胱氨酸的天冬氨酸蛋白水解酶(Caspase)-3水平与骨密度、血管钙化的关系。方法 选取行腹膜透析患者152例，入院时采用酶联免疫吸附试验检测血清跨膜受体蛋白Notch同源物(Notch)1、Caspase-3水平。采用双能X线骨密度仪测量腰椎椎体及髋部骨密度值，记录T值，测量腰1～腰4椎体正位骨密度值及T值，设立骨密度低下组与骨密度正常组。使用侧位腹部X线平片检测腹主动脉血管钙化，计算患者腹主动脉钙化(AACS)积分，设立钙化亚组与无钙化亚组。绘制受试者工作特性(ROC)曲线评价血清Notch1、Caspase-3水平对腹膜透析患者血管钙化的评估价值，采用多因素Logistic回归分析探讨影响因素。结果 骨密度低下组血清Notch1、Caspase-3水平显著高于骨密度正常组(均P<0.05)。Pearson相关分析显示，腹膜透析患者血清Notch1、Caspase-3与骨密度均呈负相关(r=-0.612,-0.673,均P<0.05)。钙化亚组血清Notch1、Caspase-3水平显著高于无钙化亚组(P<0.05)。血清Notch1、Caspase-3及两者联合预测腹膜透析患者血管钙化曲线下面积(AUC)(95%CI)分别为0.709(0.664～0.754)、0.843(0.793～0.888)、0.912(0.867～0.957)。钙化亚组年龄、透析龄、三酰甘油(TG)、血磷水平显著高于无钙化亚组(P<0.05)。多因素回归分析显示，年龄、血磷、血清Notch1、Caspase-3是腹膜透析患者血管钙化的影响因素(P<0.05)。结论 腹膜透析患者血清Notch1、Caspase-3水平与骨密度、血管钙化密切相关，且两者联合有望成为预测腹膜透析患者发生血管钙化的生物学指标。
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基本信息:
DOI：
中图分类号:R692.5
引用信息:
[1]王树龙,邢晖林,尚瑞华等.腹膜透析患者血清Notch1、Caspase-3水平与骨密度、血管钙化的关系[J].中国老年学杂志,2025,45(13):3146-3150.
基金信息:
河南省医学科技攻关计划联合共建项目(LHGJ20220591)