目的:观察糖尿病肾病患者心血管钙化的发生情况,并分析其影响因素。方法:选取慢性肾脏病(CKD)2~5期非透析糖尿病肾病患者270例(2期40例、3期121例、4期63例、5期46例),完善心血管钙化的相关实验室检查,选用螺旋CT评分冠状动脉钙化,腹部侧位平片评分腹主动脉钙化,心脏彩超观察心脏瓣膜钙化情况,并采用Logistic回归分析心血管钙化的相关危险因素。结果:CKD 2~5期患者血磷逐渐升高,血钙逐渐降低,全段甲状旁腺激素逐渐升高,25羟维生素D逐渐下降(P<0.01)。所有患者心血管钙化发生率为70.3%,其中冠状动脉钙化、腹主动脉钙化和瓣膜钙化发生率分别为55.1%、43.4%和23.9%。CKD 2~5期心血管钙化的总发生率分别为72.5%、73.6%、66.7%和63.0%。心血管钙化与年龄、糖尿病病程、高血压病程、心血管疾病史、颈部血管粥样斑块等相关,而与性别、血脂异常、血钙、血磷、全段甲状旁腺激素及CKD分期无关。其中年龄、心脑血管疾病史和颈部血管粥样斑块是冠状动脉和腹主动脉钙化的独立危险因素,年龄是心脏瓣膜钙化的独立危险因素。结论:糖尿病肾病患者心血管钙化发生率高,在CKD 2期钙磷代谢紊乱不明显时即已出现明显钙化。心血管钙化发生率与传统心血管疾病危险因素相关,而与钙磷代谢指标及CKD分期无显著相关。 Objective: To observe the occurrence of cardiovascular calcification in patients with diabetic nephropathy and to analyze its influencing factors. Methods: Two hundred and seventy patients with chronic kidney disease (CKD) from stage 2 to 5 with nondialysis diabetic nephropathy were enrolled in this study (40 cases in stage 2, 121 cases in stage 3, 63 cases in stage 4 and 46 cases in stage 5) Examination, selection of spiral CT scoring of coronary artery calcification, abdomen lateral plain film score abdominal aorta calcification, cardiac valvular heart valve calcification, and the use of Logistic regression analysis of cardiovascular calcification risk factors. Results: In patients with CKD stage 2 ~ 5, serum phosphorus levels gradually increased, serum calcium decreased gradually, parathyroid hormone increased gradually, and 25 - hydroxyvitamin D gradually decreased (P <0.01). The incidence of cardiovascular calcification in all patients was 70.3%. The incidences of coronary artery calcification, abdominal aortic calcification and valve calcification were 55.1%, 43.4% and 23.9%, respectively. The overall incidence of CKD stage 2 to 5 cardiovascular disease was 72.5%, 73.6%, 66.7% and 63.0%, respectively. Cardiovascular calcification and age, duration of diabetes, duration of hypertension, history of cardiovascular disease, cervical vascular plaque and other related, but with gender, dyslipidemia, serum calcium, phosphorus, the whole parathyroid hormone and CKD staging Nothing to do Among them, the age, the history of cardiovascular and cerebrovascular diseases and cervical vascular plaque are independent risk factors of coronary artery and abdominal aortic calcification. Age is an independent risk factor of heart valve calcification. Conclusion: The incidence of cardiovascular calcification in patients with diabetic nephropathy is high, and obvious calcification has appeared when the disorder of calcium and phosphorus metabolism in CKD stage 2 is not obvious. The incidence of cardiovascular calcification was associated with the risk factors of traditional cardiovascular disease, but not with the indexes of calcium and phosphorus metabolism and CKD staging.