中文摘要：

目的：探讨维持性血液透析患者血清可溶性肿瘤坏死因子样凋亡微弱诱导剂（s TWEAK）水平与冠状动脉钙化的关系。方法：选择维持性血液透析患者60例和健康对照组30例,采用双抗体夹心酶联免疫吸附技术测定其血清s TWEAK水平,采用多层螺旋CT（MSCT）测定其冠状动脉钙化积分（CACs）,比较两组的血清s TWEAK水平、CACs,并分析二者的相关性及血液透析患者冠状动脉钙化的危险因素。结果：血液透析患者血清s TWEAK水平显著低于正常对照组,分别为186.23（148.35,220.74）pg/m L和265.13（210.91,298.22）pg/m L,差异有统计学意义（P〈0.01）。CACs〉400的血液透析患者血清s TWEAK水平显著高于CACs≤400者,分别为220.73（189.70,251.67）pg/m L和146.07（138.43,180.11）pg/m L,差异有统计学意义（P〈0.01）。Spearman等级相关分析显示血液透析患者的血清s TWEAK水平与患者的CACs呈明显正相关（r=0.482,P〈0.01）。多因素逐步回归分析显示影响血液透析患者CACs严重程度的因素有血清s TWEAK水平、年龄、透析龄、糖尿病（P〈0.05）。结论：维持性血液透析患者血清s TWEAK水平较正常人降低,但在血液透析患者s TWEAK范围内,高水平的血清s TWEAK水平与重度冠状动脉钙化相关;血清s TWEAK可能参与了血液透析患者冠状动脉钙化的发生、发展。

英文摘要：

Objective： To investigate the association of serum soluble tumor necrosis factor-like weak inducer of apoptosis（s TWEAK） to coronary artery calcification（CAC） in maintenance hemodialysis（HD） patients. Methods： Sixty HD patients and thirty healthy volunteers were involved in the study. The levels of s TWEAK were determined by ELISA. Coronary artery calcification score（CACs） was evaluated by multislice computed tomography scans. The levels of s TWEAK and CACs in two groups were compared.Spearman analysis was used to assess correlations of s TWEAK levels with CACs and other variables. The stepwise regression analysis was used to study the predictive factors for CAC. Results： The levels of serum s TWEAK in HD patients were significantly lower than those in healthy controls [186.23（148.35, 220.74）pg/m L and 265.13（210.91, 298.22）pg/m L, respectively P〈0.01]. The levels of serum s TWEAK increased significantly in patients with CACs〉400 than those in patients with CACs≤400 [220.73（189.70, 251.67）pg/m L and146.07（138.43, 180.11）pg/m L, respectively P〈0.01]. s TWEAK level showed an positive correlation with CACs（r=0.482, P〈0.01）.Multiple stepwise regression analysis showed that independent risk factors associated with severe CAC were levels of s TWEAK, age,time on hemodialysis and diabetes（P〈0.05）. Conclusions： The levels of serum s TWEAK are decreased in maintenance HD patients.However, within the HD patients＇ range, higher s TWEAK was associated with severe CAC. Serum s TWEAK may be involved in the pathogenesis of CAC in HD patients.