摘要
目的观察慢性肾脏病（chronic kidney disease，CKD）患者血中成纤维细胞生长因子23（fibroblast growth factor23，FGF23）水平，探讨CKD患者FGF23的水平与心脏瓣膜钙化之间的关系。方法选择CKD患者89例为CKD组，28例非CKD患者为对照组；将CKD组患者根据。肾脏病／透析的临床实践指南（Kidney Disease Outcome Quality Initiative，K／DOQI），按估算肾小球滤过率（estimated glomerular filtration rate，eGFR）水平分为cKD1～2期组16例，cKD3～4期组20例，CKD5期组16例及CKD5D期组37例。应用酶联免疫分析法测定血清FGF23，同时测定血清全段甲状旁腺激素水平（parathyroid hormone，iPTH）、血钙、血磷、三酰甘油、血总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇等指标。所有患者应用超声心动检N,6脏瓣膜是否存在钙化。比较对照组及CKD1～2期组、CKD3～4期组、CKD5期组及CKD5D期组年龄、血钙、血磷、三酰甘油、血总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、iPTH、FGF23水平及糖尿病、心血管疾病、瓣膜钙化比例。根据是否存在心脏瓣膜钙化将CKD患者89例分为瓣膜钙化组14例和无瓣膜钙化组75例，比较2组问年龄、相关指标、糖尿病、冠心病及透析所占比例。结果①CKD5期组LogiPTH（2．40±0．26）及CKD5D期组（2．47±0．20）较对照组（1．57±0．14）、CKD1～2期组（1．54±0．10）、CKD3～4期组（1．82±0．29）明显升高（P〈0．001），CKD5D期组（2．67±0．54）的LogFGF23较对照组（1．37±0．11）、CKD1～2期组（1．42±0．12）、CKD3～4期组（1．62±0．26）、CKD5期组（1．83±0．37）明显升高（P〈0．001）。CKD5D期组的心脏瓣膜钙化比例（12／37）明显高于对照组（2／28）、CKD1～2期组（2／26）、CKD3～4期组（1／20）及CKD5期组（0／16），差异有统计学意义（P〈0．05）；②瓣膜钙化组的年龄[（73．3±9．9）�
Objective To determine the serum level of fibroblast growth factor 23 （FGF23） in chronic kidney disease（CKD） patients and explore the relationship between FGF23 and valvular calcifi- cation. Methods eighty-nine CKD patients and twenty-eight people（control group） whose renal func- tions were normal were enrolled in this study. The patients in CKD were divided into CKD 1-2 group （16 patients）,CKD 3-4 group（20 patients）, CKD 5 group（16 patients） and CKD 5D（37 patients）. Phosphate, calcium, triacylglycerol, total cholesterol. Low density lipoprotein cholesterol high density lipoprotein cholesterol, parathyroid hormone and FGF23 in their serum were determined. The level of FGF23 in serum were detected by the method of ELISA. All the peoples were divided to VC group and non-VC group according to echocardiogram. Results （1）The Log iPTH,Log FGF23 and valvular cal- cification in CKD 5D group was much higher than other groups. （2）The Log FGF23 and Dialysis pro- portion in VC group was much higher than non-VC group. （3） Logistic regression analysis revealed that the level of Log FGF23,age, Hypercholesterolemia and history of diabetes mellitus was the influ- encing factor of CKD patients. Conclusions The serum level of FGF23 in CKD patients is higher. With the worsening of renal function, FGF23 increased, and the elevation of FGF23 is relative to the valvular calcification.
出处
《临床肾脏病杂志》
2015年第1期7-11,共5页
Journal Of Clinical Nephrology
基金
西城区卫生局青年科技人才(科技新星)培养项目(NO.XWKX2014-03)
关键词
成纤维细胞生长因子23
瓣膜钙化
慢性肾脏病
Fibroblast growth factor 23
Valvular calcification
Chronic kidney disease
