肾透析患者血清HIF-2α、RBP4水平变化及对动静脉内瘘功能障碍的预测价值OA
Serum HIF-2α and RBP4 levels and their predictive value for arteriovenous fistula dysfunction in hemodialysis patients
目的 探讨肾透析患者血清缺氧诱导因子-2α(HIF-2α)、视黄醇结合蛋白4(RBP4)水平的变化及对动静脉内瘘(AVF)功能障碍的预测价值.方法 回顾性选取2022年1月至2023年12月在重庆医科大学附属两江医院接受肾透析的150例患者作为研究对象(肾透析组),另选取同期来院健康体检的75例志愿者作为对照(对照组).采用酶联免疫吸附分析检测纳入对象血清HIF-2α、RBP4水平.通过多因素logistic回归分析肾透析患者AVF功能障碍的危险因素;使用ROC曲线分析血清HIF-2α、RBP4水平对肾透析患者AVF功能障碍的预测价值.以ROC曲线获得的截断值将肾透析患者根据血清HIF-2α、RBP4水平分为高低水平组,Kaplan-Meier法比较不同水平分组患者的生存差异.结果 与对照组比较,肾透析组血清HIF-2α、RBP4水平显著升高(均P＜0.05).随访1年,150例肾透析患者发生AVF功能障碍55例,障碍发生率为36.67％.糖尿病、高HIF-2α水平、高RBP4水平均为肾透析患者AVF功能障碍的独立危险因素(均P＜0.05).血清HIF-2α、RBP4水平联合预测肾透析患者AVF功能障碍的AUC为0.884,大于血清HIF-2α、RBP4水平单独预测的0.812、0.783(均P＜0.05).HIF-2α、RBP4高水平组1年无AVF功能障碍生存率低于HIF-2α、RBP4低水平组(均P＜0.05).结论 肾透析患者血清HIF-2α、RBP4水平升高,与AVF功能障碍密切相关,血清HIF-2α、RBP4水平联合预测AVF功能障碍具有较高效能.
Objective To investigate the serum levels of hypoxia inducible factor-2α(HIF-2α)and retinol binding protein 4(RBP4)in hemodialysis patients and their predictive value for arteriovenous fistula(AVF)dysfunction.Methods A total of 150 hemodialysis patients treated at the Chongqing Medical University Affiliated Liangjiang Hospital from January 2022 to December 2023 were retrospectively enrolled(hemodialysis group).Seventy-five healthy volunteers who underwent physical examination during the same period were included as the control group.Serum HIF-2α and RBP4 levels were measured using enzyme-linked immunosorbent assay.Multivariate logistic regression analysis was performed to identify risk factors for AVF dysfunction of hemodialysis patients.ROC curves were constructed to assess the predictive value of HIF-2α and RBP4 levels for their AVF dysfunction.Based on ROC-derived cutoff values,patients were divided into high-and low-level groups for serum HIF-2α and RBP4,and Kaplan-Meier analysis was performed to compare survival of patients in different level groups.Results Serum HIF-2α and RBP4 levels were significantly higher in the hemodialysis group than in the control group(all P＜0.05).During one-year follow-up,AVF dysfunction occurred in 55 of 150 hemodialysis patients,with an incidence of 36.67％.Diabetes,high HIF-2α and high RBP4 levels were identified as independent risk factors for AVF dysfunction of hemodialysis patients(all P＜0.05).The AUC of combined serum HIF-2α and RBP4 levels in predicting AVF dysfunction of hemodialysis patients was 0.884,which was higher than that of serum HIF-2α(0.812)or RBP4(0.783)alone(all P＜0.05).The one-year AVF dysfunction-free survival rate was lower in the high HIF-2α level and high RBP4 level groups compared with their low-level groups(all P＜0.05).Conclusion Elevated serum HIF-2α and RBP4 levels are closely associated with AVF dysfunction in hemodialysis patients.Combined detection of HIF-2α and RBP4 provides a higher predictive value for AVF dysfunction.
蓝燕青;丁瑜;罗琼;唐茂;陈纯娟
401121 重庆医科大学附属两江医院肾内科401121 重庆医科大学附属两江医院肾内科401121 重庆医科大学附属两江医院肾内科401121 重庆医科大学附属两江医院肾内科401121 重庆医科大学附属两江医院肾内科
肾透析缺氧诱导因子-2α视黄醇结合蛋白4动静脉内瘘功能障碍
HemodialysisHypoxia-inducible factor-2αRetinol binding protein 4Arteriovenous fistula dysfunction
《浙江医学》 2026 (9)
908-913,6
重庆市自然科学基金资助项目(cstc2021jcyj-msxmX0857)
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