| 摘要: |
| 目的 探讨血清缺氧诱导因子-2α（HIF-2α）、视黄醇结合蛋白4（RBP4）水平与肾透析患者动静脉内瘘（AVF）功能障碍的相关性。方法 回顾性选取2022年1月～2023年12月在重庆医科大学附属两江医院肾内科接受肾透析患者150例（肾透析组），根据1年后AVF功能分为功能障碍组和功能良好组，另按照2:1比例选取同期来院健康体检志愿者75例（对照组）。采用酶联免疫吸附法检测血清HIF-2α、RBP4水平。通过多因素非条件Logistic回归分析血清HIF-2α、RBP4水平与肾透析患者AVF功能障碍的关系；ROC曲线分析血清HIF-2α、RBP4水平对肾透析患者AVF功能障碍的预测效能。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法绘制不同血清HIF-2α、RBP4水平肾透析患者无AVF功能障碍的生存曲线。结果 与对照组比较，肾透析组血清HIF-2α、RBP4水平升高（P＜0.05）。随访1年，150例AVF功能障碍率为36.67%（55/150）。与功能良好组比较，功能障碍组血清HIF-2α、RBP4水平升高（P＜0.05）。糖尿病、HIF-2α高、RBP4高为肾透析患者AVF功能障碍的独立危险因素（P＜0.05）。血清HIF-2α、RBP4水平联合预测肾透析患者AVF功能障碍的曲线下面积为0.884，大于血清HIF-2α、RBP4水平单独预测的0.812、0.783（P＜0.05）。150例肾透析患者1年无AVF功能障碍生存率为63.33%（95/150）。HIF-2α、RBP4高水平组无AVF功能障碍生存率低于HIF-2α、RBP4低水平组（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水平联合对AVF功能障碍的预测效能较高。 |
| 关键词: 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 预测 |
| DOI： |
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| 基金项目:重庆市自然科学基金面上项目（cstc2021jcyj-msxmX0857） |
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| Correlation Between Serum HIF-2α and RBP4 Levels and Arteriovenous Fistula Dysfunction in Hemodialysis Patients |
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Lan Yanqing, Ding Yu, Luo Qiong, Tang Mao, Chen Chunjuan
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Chongqing Medical University Affiliated Liangjiang Hospital
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| Abstract: |
| Objective To investigate the correlation between serum hypoxia-inducible factor-2α (HIF-2α) and retinol-binding protein 4 (RBP4) levels and arteriovenous fistula (AVF) dysfunction in hemodialysis patients. Methods A retrospective study was conducted on 150 hemodialysis patients (hemodialysis group) admitted to the Department of Nephrology, Liangjiang Hospital, Chongqing Medical University, from January 2022 to December 2023. Based on AVF function at the one-year follow-up, patients were divided into the dysfunction group and the well-functioning group. Additionally, 75 healthy volunteers (control group) were selected in a 2:1 ratio. Serum HIF-2α and RBP4 levels were measured using enzyme-linked immunosorbent assay. Multivariate unconditional logistic regression was used to analyze the relationship between serum HIF-2α, RBP4 levels, and AVF dysfunction in hemodialysis patients. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive value of serum HIF-2α and RBP4 levels for AVF dysfunction. Based on the cut-off values obtained from the ROC curves, hemodialysis patients were divided into high and low-level groups for HIF-2α and RBP4. Kaplan-Meier survival curves were used to analyze AVF dysfunction-free survival rates. Results Compared with the control group, serum HIF-2α and RBP4 levels were significantly elevated in the hemodialysis group (P＜0.05). After a one-year follow-up, the incidence of AVF dysfunction among 150 patients was 36.67% (55/150). Compared with the well-functioning group, the dysfunction group had significantly higher serum HIF-2α and RBP4 levels (P＜0.05). Diabetes, high HIF-2α, and high RBP4 levels were identified as independent risk factors for AVF dysfunction in hemodialysis patients (P＜0.05). The area under the ROC curve (AUC) for the combined prediction of AVF dysfunction using serum HIF-2α and RBP4 was 0.884, which was higher than the AUC for HIF-2α (0.812) and RBP4 (0.783) alone (P＜0.05). The one-year AVF dysfunction-free survival rate among the 150 hemodialysis patients was 63.33% (95/150). Patients with high HIF-2α and RBP4 levels had significantly lower AVF dysfunction-free survival rates compared to those with low levels (P＜0.05). Conclusion Elevated serum HIF-2α and RBP4 levels are closely associated with AVF dysfunction in hemodialysis patients. The combined detection of serum HIF-2α and RBP4 levels has a high predictive value for AVF dysfunction. |
| Key words: Hemodialysis Hypoxia-inducible factor-2α Retinol-binding protein 4 Arteriovenous fistula dysfunction Prediction |