摘要
目的探讨碱性成纤维细胞生长因子(b-FGF)、血清和糖皮质激素诱导的蛋白激酶3(SGK3)表达与血液透析(HD)患者动静脉内瘘(AVF)失功的关系。方法选择2019年1月至2021年12月在洛阳市东方人民医院接受HD的80例患者为研究对象(观察组),另选择同期入院体检健康者30例作为对照组。根据是否伴有AVF失功将观察组患者分为AVF失功组(n=31)和AVF未失功组(n=49)。采用酶联免疫吸附法检测所有受试者血清中b-FGF水平,采用免疫组织化学法检测血清中SGK3水平;并比较观察组和对照组受试者血清中b-FGF、SGK3水平。收集观察组患者的临床资料,采用单因素和多因素logsitic回归分析HD患者发生AVF失功的危险因素,并重点观察血清b-FGF、SGK3水平与HD患者AVF失功的关系。绘制受试者操作特征(ROC)曲线评估b-FGF、SGK3对HD患者发生AVF失功的预测价值。结果观察组患者血清中b-FGF、SGK3水平显著高于对照组(P<0.05)。单因素分析结果显示,AVF失功组与AVF未失功组患者的年龄、透析时间、透析频率、白细胞(WBC)计数、血细胞比容(Hct)、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、血小板(PLT)计数及b-FGF、SGK3、空腹血糖(FPG)、肌钙蛋白T(TnT)、降钙素原(PCT)、血尿酸(UA)、高密度脂蛋白(HDL)水平和糖尿病史、抽烟史占比比较差异有统计学意义(P<0.05);logistic回归分析结果显示,高b-FGF、SGK3、NLR、PLR水平及透析频率和长时间透析是HD患者发生AVF失功的独立危险因素(P<0.05)。ROC曲线分析结果显示,血清b-FGF预测HD患者发生AVF失功的灵敏度、特异度分别为85.96%、69.57%,血清SGK3预测HD患者发生AVF失功的灵敏度、特异度分别为87.72%、73.91%;二者联合检测预测HD患者发生AVF失功的灵敏度、特异度分别为91.53%、85.71%。结论HD导致AVF失功患者血清中b-FGF、SGK3水平升高,二者联合检测对HD患者发生AVF失功具有较高的预测�
Objective To investigate the relationship between the expression of basic fibroblast growth factor(b-FGF),serum and glucocorticoid-induced protein kinase 3(SGK3)and the dysfunction of autogenous arteriovenous fistulas(AVF)in hemodialysis(HD)patients.Methods A total of 80 patients who received HD in Luoyang Dongfang People′s Hospital from January 2019 to December 2021 were selected as the study subjects(observation group),and 30 healthy individuals who underwent physical examination during the same period were selected as the control group.The patients in the observation group were divided into AVF dysfunction group(n=31)and AVF non-dysfunction group(n=49)according to whether they were accompanied with AVF dysfunction.The serum b-FGF level of all subjects was detected by enzyme linked immunosorbent assay,the serum SGK3 level of all subjects was detected by immunohistochemistry;and the serum b-FGF,SGK3 levels of all subjects were compared between the observation group and the control group.The clinical data of patients in the observation group were collected,and the risk factors of AVF dysfunction in HD patients were analyzed by univariate and multifactorial logsitic regression,and the relationship between serum b-FGF,SGK3 levels and AVF dysfunction in HD patients was mainly observed.Receiver operating characteristic(ROC)curve was drawed to evaluate the predictive value of b-FGF and SGK3 for AVF dysfunction in HD patients.Results The serum levels of b-FGF and SGK3 of patients in the observation group were significantly higher than those in the control group(P<0.05).The results of univariate analysis showed that there was significant difference in the age,dialysis time,dialysis frequency,white blood cell(WBC)count,hematocellular volume(Hct),neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR),platelet(PLT)count and b-FGF,SGK3,fasting blood glucose(FPG),troponin T(TnT),procalcitonin(PCT),blood uric acid(UA),high-density lipoprotein(HDL)levels and the proportion of diabetes history and smoking history of
作者
王岩
张爱霞
王紫晖
王谦受
WANG Yan;ZHANG Aixia;WANG Zihui;WANG Qianshou(Department of Blood Purification,Luoyang Dongfang People′s Hospital,Luoyang 471003,Henan Province,China)
出处
《新乡医学院学报》
CAS
2023年第9期851-855,共5页
Journal of Xinxiang Medical University
