关键词: 肾透析, 血管钙化, 心脏瓣膜钙化, sclerostin

Abstract: Objective  To observe the calcification of cardiac valves in patients undergoing maintenance hemodialysis (MHD), to investigate the factors affecting sclerostin and analyze the correlations between sclerostin and valves calcifications. Methods  A total of  50 patients undergoing MHD at the Second Hospital of Hebei Medical University were selected as experiment group subjects, and 35 healthy persons were selected as the control group. Clinical data were collected, and  ELISA were applied to measure the serum sclerostin level and cardiac doppler ultrasound were used to assess the calcification of cardiac valves.  The correlation analysis was applied to the results.Results  Significant difference on cardiac valves calcification was observed between experimental and control groups (40% vs 8.6%, P<0.05). The serum sclerostin level was negatively correlated to intact parathyroid hormone(iPTH)(r=-0.283,P=0.046) and alkaline phosphatase(r=-0.407,P=0.003), positively correlated to the rate of cardiac valves calcifications (r=0.408, P=0.046).The average age of patients with and without valves calcification is  47.5(33.8~62.3)  vs  69.5（56.577.5）. Serum sclerostin level are lower in patients without valves calcification than that of patients with valves calcification  ［5.66（4.398.09） ng/ml vs  8.28（6.4012.37）  ng/ml］, while the serum phosphate level is higher(2.14±0.55 mmol/L vs 1.81±0.56 mmol/L), the difference is statistically significant. The age and serum sclerostin level are the independent risk factors of cardiac valves calcification, OR values are 6.794，95%CI=1.47431.318（P=0.014）；6.74，95%CI=1.61328.157（P=0.021）, respectively. The iPTH and ALP level are significantly higher in group with lower sclerostin level, 252（168524.5）  pg/ml vs 139（59.5343） pg/ml and 78.0(63.6~81.0)  U/L vs 62.0（59.069.0）U/L，the difference is statistically significant (P<0.05). For calcification, the rate of abdominal aortic valve and cardiac valve calcification is higher in patients with higher serum sclerostin level, （84% vs 44% and 60% vs 20%). The difference is statistically significant (P<0.05).Conclusion  The rate of vascular calcification is higher in MHD patients, and cardiac valve calcification is positively correlated to serum sclerostin level. Both age and serum sclerostin level are risk factors of cardiac valve calcification. Sclerostin can be used as a new biomarker for vascular calcification in MHD patients.

Key words: renal dialysis； vascular calcification；valve calcification, , sclerostin