终末期肾病患者血清成纤维细胞生长因子23的变化及临床意义  

Changes of serum fibroblast growth factor 23 in patients with end stage renal disease and its clinical significance

作　　者：张军力[1] 宦红娣[1] 张景红[1] 杨峻[1] 陆蓓莉[1] 杨黄[1] 

机构地区：[1]解放军第85医院肾内科,上海200052

出　　处：《第二军医大学学报》2008年第10期1184-1187,共4页Academic Journal of Second Military Medical University

摘　　要：目的:观察终末期肾病患者血清成纤维细胞生长因子23(FGF-23)水平及其与钙磷代谢的关系。方法:采集50例血透患者、24例腹透患者及20名健康对照者的静脉血,离心取血清,采用ELISA法测定FGF-23水平,同时检测水平在1,25-二羟维生素D[1,25-(OH)2VitD]、全段甲状旁腺激素(iPTH)、血清肌酐(Scr)、钙(Ca)、磷(P)等水平。结果:FGF-23水平在血透组患者[(88.51±35.01)ng/L]、腹透组患者[(87.85±33.65)ng/L]均明显高于健康人群[(11.76±3.63)ng/L],但血透组和腹透组无统计学差异。而血透组、腹透组患者血清1,25-(OH)2VitD水平均明显低于健康对照组(P<0.01),且血透组明显低于腹透组(P<0.01)。Pearson相关性分析结果显示血清FGF-23与血清肌酐、iPTH、磷、透析时间呈正相关(P<0.01),与1,25-(OH)2VitD负相关(P<0.01)。结论:终末期肾病患者FGF-23水平明显升高,1,25-(OH)2VitD明显降低。FGF-23水平变化与血清肌酐、iPTH、磷、透析时间、1,25-(OH)2VitD等多种因素有关。Objective：To observe the serum level of fibroblast growth [actor-23（FGF-23） in patients with end stage renal disease （ESRD） and study its association with phosphorus and vitamin D metabolism. Methods： Serum FGF-23 level was determined by enzyme-linked immunosorbent assay （ELISA） in ESRD patients undergoing haemodialysis （HD, n = 50） and peritoneal dialysis （PD, 11= 24） and in twenty healthy controls （control group, n =20）. Serum level of 1,25-（OH） z VitD was measured by enzyme immunoassay（EIA）. Serum intact parathyroid hormone （PTH）, creatinine, and calcium and phosphorus were also measured. Results： Serum FGF-23 was obviously higher in HD group（[88.51 ±35. 013 ng/L vs [11.76± 3. 631 ng/L） and PD group（[87.85±33. 65] ng/L vs [11. 76±3. 63] ng/L）than in control group. Moreover, the serum level of 1,25- （OH）2VitD was lower in HD and PD groups than in control group （[19.82±4. 991 pmol/L vs [48. 37±3. 47] pmol/L; [24.31±7.11] pmol/L vs[48.37±3. 471 pmol/L ）, and the level of 1,25-（OH）zVitD was much lower in HD group than in PD group. Pearson relativity analysis showed that serum FGF-23 level was positively correlated with serum creatinine, phosphorus, intact PTH and duration of dialysis（ P〈0.01 ） ; and was negatively correlated with 1,25-（OH ）2 VitD（ P〈0.01 ）. Conclusion： Serum FGF-23 is greatly up-regulated in patients with ESRD, and the level of serum 1,25-（OH）zVitD is down- regulated. The changes of FGF-23 is associated with serum creatinine, phosphorus, intact PTH and 1,25-（OH）2VitD.

关 键 词：成纤维细胞生长因子 终末期肾病 磷 1 25-二羟维生素D 

分 类 号：R692[医药卫生—泌尿科学]