谭菲 罗丽花 彭娟 舒桥 何勇 盛瑶环

【摘要】 目的：探討维生素K2对慢性肾脏病（CKD）患者血管钙化的干预效果。方法：选取2018年

9月-2019年6月本院收治的CKD患者80例，按照随机数字表法为试验组（n=40）和对照组（n=40）。对照组采用CKD常规药物治疗，而试验组在对照组的基础上给予维生素K2治疗，两组患者均治疗6个月。比较两组治疗前后血清钙磷代谢、骨代谢、炎症因子、基质-γ-羧基谷氨酸蛋白（MGP）、生长停滞特异性蛋白6（GAS6）及冠脉钙化积分（CACS）。结果：两组治疗前后hs-CRP、IL-6、PTH组间与组内比较，差异均无统计学意义（P>0.05）。而对照组治疗后GAS6、MGP、CACS较治疗前均明显升高（P<0.05），维生素K2较治疗前没有变化（P>0.05）;但试验组治疗后GAS6、MGP和CACS较治疗前均明显降低，维生素K2较治疗前均升高，差异均有统计学意义（P<0.05）;试验组治疗后GAS6、MGP和CACS均低于对照组，维生素K2高于对照组，差异均有统计学意义（P<0.05）。Pearson相关性分析结果显示，试验组CKD患者血清维生素K2水平与GAS6、MGP及CACS均呈负相关（P<0.05）。结论：血清维生素K2水平与CKD患者血管钙化密切相关，补充维生素K2可通过羧化血管钙化抑制蛋白来抑制血管钙化。

【关键词】 维生素K2 慢性肾脏病 血管钙化 基质-γ-羧基谷氨酸蛋白

Intervention Study of Vitamin K2 on Vascular Calcification in Patients with Chronic Kidney Disease/TAN Fei， LUO Lihua， PENG Juan， SHU Qiao， HE Yong， SHENG Yaohuan. //Medical Innovation of China， 2021， 18（32）： -160

[Abstract] Objective： To investigate the intervention effect of Vitamin K2 on vascular calcification in patients with chronic kidney disease （CKD）. Method： From September 2018 to June 2019， a total of 80 patients with chronic kidney disease （CKD） treated in our hospital were selected and divided into the experimental group （n=40） and the control group （n=40） according to random number table method. The control group was treated with CKD conventional drugs， while the experimental group was treated with Vitamins K2 on the basis of the control group. Both groups were treated for 6 months. The serum calcium and phosphorus metabolism， bone metabolism， inflammatory factors and matrix-γ-Carboxyglutamic acid protein （MGP）， growth arrest specific protein 6 （GAS6） and coronary artery calcium score （CACS） were compared between two groups before and after treatment. Result： Comparison of hs-CRP， IL-6 and PTH between and within the two groups before and after treatment， there were no significant differences （P>0.05）. The GAS6， MGP and CACS in the control group after treatment were significantly increased compared with those before treatment （P<0.05）， while vitamin K2 after treatment was not changed compared with that of before treatment （P>0.05）. However， the GAS6， MGP and CACS in the experimental group after treatment were significantly decreased compared with those before treatment， while vitamin K2 after treatment was increased compared with that before treatment， there were significant differences （P<0.05）. After treatment， the GAS6， MGP and CACS in the experimental group were lower than those in the control group， while vitamin K2 was higher than that in the control group， there were significant differences （P<0.05）. Pearson correlation analysis showed the serum vitamin K2 level of CKD patients in the experimental group was negatively correlated with GAS6， MGP and CACS （P<0.05）. Conclusion： Serum vitamin K2 level is closely related to vascular calcification in patients with CKD， and vitamin K2 supplementation can inhibit vascular calcification by carboxylation of vascular calcification inhibitor protein.

[Key words] Vitamin K2 Chronic kidney disease Vascular calcification Matrix-γ-carboxylic glutamate protein

First-author’s address： Ganzhou People’s Hospital， Ganzhou 341000， China

doi：10.3969/j.issn.1674-4985.2021.32.039

慢性腎脏病（chronic kidney disease，CKD）由于具病程有长、并发症多且病情呈不可逆性进展的特点，现已成为严重威胁人类健康的重要疾病，40%～50%的CKD终末期肾衰患者由于心血管疾病而死亡，其中血管钙化是导致心血管疾病发生的重要危险因素[1-2]。但目前CKD患者出现血管钙化的确切机制仍不太清楚，除可能与CKD矿物质和骨异常导致患者体内钙（Ga）、磷（P）等矿……