终末期肾病患者成纤维细胞生长因子23-Klotho调节轴与血管内皮功能的关系  

Association between fibroblast growth factor 23-Klotho adjustment shaft and vascular endothelial function in patients with end stage renal disease

作　　者：李旻[1] 周华[1] 周萃星[2] 杨敏[1] 

机构地区：[1]苏州大学附属第三医院肾内科,江苏常州213001 [2]苏州大学附属第三医院泌尿外科,江苏常州213001

出　　处：《临床荟萃》2014年第7期765-769,共5页Clinical Focus

摘　　要：目的探讨终末期肾病(end stage renal disease,ESRD)患者成纤维细胞生长因子23(fibroblast growth factor 23,FGF23)-Klotho调节轴与血管内皮功能表达因子一氧化氮(nitric oxide,NO)、内皮素1(endothelin-1,ET-1)的关系。方法收集确诊为ESRD并规律行血液透析、腹膜透析治疗患者50例,同时选取正常对照组30例,利用酶联免疫吸附法检测各组血清Klotho蛋白、FGF23以及血管内皮功能表达因子NO、ET-1的表达水平,比较组间差异,并行相关性分析。结果血液透析组、腹膜透析组血清Klotho蛋白浓度分别为(59.1±21.1)U/L、(66.0±27.9)U/L,较正常对照组(107.6±17.2)U/L明显降低,差异有统计学意义(P<0.01);血液透析组的FGF23、NO、ET-1的表达分别为(1 025.8±963.4)ng/L、(114.4±20.9)μmol/L、(107.5±16.9)ng/L;腹膜透析组FGF23、NO、ET-1的表达分别为(987.6±834.2)ng/L、(123.5±19.7)μmol/L、(96.5±19.1)ng/L,较正常对照组(26.6±14.4)ng/L、(38.7±17.8)μmol/L、(40.7±19.0)ng/L明显增高,差异有统计学意义(P<0.01);ESRD患者血清Klotho蛋白与FGF23、ET-1呈负相关,与NO无相关性;FGF23与ET-1呈正相关,与NO无相关性。结论 ESRD患者存在血清FGF23、Klotho蛋白浓度的改变,且与血管内皮功能损伤有关。Objective To investigate the association between fibroblast growth factor 23（FGF23）-Klotho adjustment shaft and endothelial nitric oxide（NO）,endothelin-1（ET-1）,which are expressed by vascular endothelial cells in patients with end stage renal disease（ESRD）.Methods Fifty hematodialysis（HD）patients,50peritoneal dialysis（PD）patients and 30normal controls were involved in the study.The serum concentrations of Klotho,FGF23,NO and ET-1 were determined by enzyme-linked immunosorbent assay（ELISA）.The association between FGF23-Klotho adjustment shaft and the factors expressed by vascular endothelial cells were studied.Results The serum concentrations of Klotho in HD and PD patients were（59.1±21.1）U/L and（66.0±27.9）U/L,respectively,which were significantly lower than that in normal control group（107.6±17.2）U/L（P〈 0.01）.The serum concentrations of FGF23,NO and ET-1in HD and PD patients were（1 025.8±963.4）ng/L vs（987.6±834.2）ng/L,（114.4±20.9）μmol/L vs（123.5±19.7）μmol/L,（107.5±16.9）ng/L vs（96.5±19.1）ng/L,respectively,which were significantly higher than those in normal control group（26.6±14.4）ng/L,（38.7±17.8）μmol/L,（40.7±19.0）ng/L（P〈 0.01）.Negative correlations existed between Klotho and FGF23,as well as ET-1.Positive correlation proved between FGF23and ET-1,but no had no correlations with FGF23or Klotho.Conclusion The changes of serum FGF23and Klotho in ESRD patients were closely related with vascular endothelial dysfunction.

关 键 词：肾病 成纤维细胞生长因子 一氧化氮 内皮素-1 

分 类 号：R256.59[医药卫生—中医内科学]