中文摘要：

目的 研究CKDV期患者血中高级蛋白氧化产物（AOPP）水平及其与动脉钙化的关系，并探讨AOPP可否诱导动脉平滑肌细胞向成骨细胞分化。方法 50例CKDV期患者为尿毒症组，10例肾功能正常的胸腺瘤患者作为对照组。测定血AOPP、钙、磷、甲状旁腺激素（iPTH）水平，同时分别取桡动脉和同级别的胸廓内动脉做组织学检查。体外用次氯酸处理的人血清白蛋白（AOPP-HSA）作用于主动脉平滑肌细胞（HASMC），以单纯人血清白蛋白（HSA）培养基和常规培养基作为对照，RT—PCR法检测核结合因子α-1（CBFα-1）及骨桥蛋白（OPN）水平。结果CKDV期患者血浆AOPP水平明显高于对照组[（90．22±55．88）μmol／L比（35．79±4．31）μmol／L，P〈0．01]。50例桡动脉标本中44例有OPN沉积于中膜（88％），其中24例有明显的钙化（48％），对照组无一例有OPN沉积及钙化。Pearson相关分析显示血清AOPP水平与桡动脉内膜中层厚度（IMT）（r=0．691，P〈0．01）及管壁／管腔比值（r=0．354，P〈0．05）呈正相关。血管钙化程度与AOPP（r=0．791，P〈0．01）、血清磷（r=0．602，P〈0．01）、iPTH水平（r=0．549，P〈0．05）呈正相关。体外试验显示AOPP-HSA可诱导HASMC表达CBFα-1和OPN，而单纯HSA无此效应。结论 CKDV期患者普遍存在高AOPP血症和血管钙化，血AOPP水平与血管钙化密切相关。这可能与AOPP直接诱导动脉平滑肌细胞向成骨细胞分化有关。

英文摘要：

Objective To study the relationship between plasma advanced oxidation protein products （AOPP） and vascular calcification in uremic patients and to investigate the role of AOPPHSA in osteoblast differentiation of human aortic smooth muscle cell （HASMC） in vitro. Methods Fifty patients with CKD stage V were included in study and pieces of radial arteries were taken during the arteriovenous fistula operation. Ten patients with thymoma and normal renal function were chosen as controls. Pieces of internal thoracic artery were taken in the operation. The vessels were examined for calcification by alizarin red staining and for the presence of osteopontin（OPN） by immunohistochemistry. Measurements of intima-media thickness （IMT） and wall-to-lumen ratio of radial arteries were assessed with HE staining. Plasma AOPP and blood chemistry, including serum calcium, phosphate, iPTH were analyzed. AOPP-HSA was prepared in vitro with human serum albumin （HSA） and hypochloric acid. The effect of AOPP-HSA on the expression of OPN and core binding factor α1 （CBFα-1） were examined by real-time PCR in HASMC in vitro. Results Plasma AOPP levels in patients with CKD stage V were significantly higher than those in controls [（90.22±55.88） vs （35.79±4.31）μmol/L, P 〈 0.01]. Vascular calcification was found in the media of the vessels of 24 uremic patients （48%）, while not in controls. OPN was expressed in the media of the vessels of 44 uremic patients （88%）, but there was little staining in control vessels. OPN was observed in all calcified vessels, and in 20 of the 26 non-calcified vessels （76.9%）. Patients with calcified vessels showed remarkably higher levels of AOPP as compared with those without calcified vessels [（122.52±66.9） vs （61.29±31.23） μmol/L, P 〈 0.01]. Pearson correlation analysis showed that plasma levels of AOPP were positively correlated with the extent of calcification （r = 0.791, P 〈 0.01）, IMT （r = 0.691, P 〈 0.01） and wall-to-lumen ratio （r