sST2、IL-33在维持性血液透析患者血管钙化中的表达研究

Study on Expression of sST2 and IL-33 in Vascular Calcification of Maintenance Hemodialysis Patients

摘要: 目的：探讨维持性血液透析患者血清可溶性ST2 (sST2)、白介素-33 (IL-33)表达水平与血管钙化的关系。方法：选取2018年1月~2020年7月本院收治的150维持性血液透析患者为研究对象，根据钙化评分将维持性血液透析患者分为无钙化组60例、轻度钙化组51例、重度钙化组39例。采用酶联免疫吸附(ELISA)法检测血清sST2、IL-33、甲状旁腺激素(PTH)水平；采用全自动生化分析仪检测血清生化指标钙、磷、镁、白蛋白(Alb)水平；分析维持性血液透析血管钙化患者血清sST2、IL-33与钙化评分及生化指标的相关性；分析影响维持性血液透析患者血管钙化的因素。结果：重度钙化组sST2、IL-33、钙化评分、磷、钙磷乘积、PTH水平高于轻度钙化组和无钙化组，镁、Alb水平低于轻度钙化组和无钙化组(P < 0.05)；轻度钙化组sST2、IL-33、钙化评分、磷、钙磷乘积、PTH水平高于无钙化组，镁、Alb水平低于无钙化组(P < 0.05)。维持性血液透析血管钙化患者血清sST2与IL-33呈正相关(r = 0.385；P < 0.05)；维持性血液透析血管钙化患者血清sST2、IL-33与磷、钙磷乘积、PTH、钙化评分呈正相关，与镁、Alb呈负相关(P < 0.05)。sST2、IL-33是影响维持性血液透析患者血管钙化的独立危险因素(P < 0.05)，Alb是影响维持性血液透析患者血管钙化的保护因素(P < 0.05)。结论：随着维持性血液透析患者血管钙化加重，血清sST2、IL-33表达水平呈升高趋势，二者与钙化评分呈正相关，可能对评估患者血管钙化严重程度有重要意义。

Abstract: Objective: To investigate the relationship between serum soluble ST2 (sST2), interleukin-33 (IL-33) expression levels and vascular calcification in maintenance hemodialysis patients. Methods: From January 2018 to July 2020, 150 patients with maintenance hemodialysis in our hospital were se-lected as the research objects. According to the calcification score, the patients were divided into non calcification group (60 cases), mild calcification group (51 cases) and severe calcification group (39 cases). The levels of serum sST2, IL-33 and parathyroid hormone (PTH) were detected by en-zyme-linked immunosorbent assay (ELISA); the levels of serum calcium, phosphorus, magnesium and Albumin (Alb) were detected by automatic biochemical analyzer; the correlation of serum sST2 and IL-33 with calcification score and biochemical indexes was analyzed; the influencing factors of vascular calcification in maintenance hemodialysis patients were analyzed. Results: The levels of sST2, IL-33, calcification score, phosphorus, calcium phosphorus product and PTH in severe calcifi-cation group were higher than those in mild calcification group and non calcification group, while the levels of magnesium and Alb were lower than those in mild calcification group and non calcifica-tion group (P < 0.05); the levels of sST2, IL-33, calcification score, phosphorus, calcium phosphorus product and PTH in mild calcification group were higher than those in non calcification group, while the levels of magnesium and Alb were lower than those in non calcification group (P < 0.05). There was a positive correlation between serum sST2 and IL-33 in maintenance hemodialysis patients with vascular calcification (r = 0.385; P < 0.05); serum sST2 and IL-33 were positively correlated with phosphorus, calcium phosphorus product, PTH and calcification score, but negatively corre-lated with magnesium and Alb (P < 0.05). sST2 and IL-33 were independent risk factors of vascular calcification in maintenance hemodialysis patients (P < 0.05), Alb was a protective factor of vascular calcification in maintenance hemodialysis patients (P < 0.05). Conclusions: With the aggravation of vascular calcification in maintenance hemodialysis patients, the expression levels of serum sST2 and IL-33 show an increasing trend, and they are positively correlated with the calcification score, which may be of great significance in evaluating the severity of vascular calcification in patients with maintenance hemodialysis.