中晚期慢性肾脏病患者成纤维细胞生长因子23水平与颈动脉粥样硬化的关系  

Association of Fibroblast Growth Factor 23 with Carotid Atherosclerosis in Patients with Moderate and Advanced Stage Chronic Kidney Disease

作　　者：曹娟[1] 印荻[1] 章旭[1] 丁浩[1] 许琴[1] 周长菊[1] 危志强[1] 

机构地区：[1]泰兴市人民医院肾内科,江苏省泰兴市225400

出　　处：《中国动脉硬化杂志》2014年第6期595-601,共7页Chinese Journal of Arteriosclerosis

基　　金：江苏省卫生厅面上科研课题(H200834)

摘　　要：目的探讨中晚期慢性肾脏病（CKD）患者成纤维细胞生长因子23（FGF23）水平与颈动脉粥样硬化的相关性。方法收集我院中晚期慢性肾脏病患者共计120例,分为3组,其中CKD非透析组患者（3-5期）30例、腹膜透析组患者30例、血液透析组患者60例;另外选择年龄、性别匹配的20例健康体检者为健康对照组。比较中晚期慢性肾脏病患者与健康人群FGF23水平的差别,以及3组之间的差别。同时将中晚期CKD患者分为颈动脉粥样硬化组和无颈动脉粥样硬化组,比较两组临床有关参数及FGF23水平的变化,探讨FGF23水平与颈动脉粥样硬化的相关性,分析其临床意义。结果中晚期CKD患者颈动脉粥样硬化发生率较高（59/120,49.2%）。颈动脉粥样硬化组血清FGF23水平明显高于无颈动脉粥样硬化组（P〈0.01）;中晚期CKD患者血清FGF23水平显著高于健康对照组（P〈0.01）;中晚期CKD患者3组人群比较,透析患者FGF23水平高于非透析的CKD 3-5期患者（P〈0.05）;血液透析患者的FGF23水平又显著高于腹膜透析患者（P〈0.01）。中晚期CKD患者FGF23水平与颈动脉内膜中层厚度呈正相关（r=0.68,P〈0.05）,多因素分析显示,FGF23水平是中晚期慢性肾脏病患者发生颈动脉粥样硬化的独立危险因素。结论血清FGF23水平与中晚期CKD患者颈动脉粥样硬化的发生相关,FGF23在颈动脉粥样硬化的发生发展中可能起着重要作用。FGF23可能成为预测CKD患者发生心血管疾病和死亡风险性增高的更敏感的标志物之一。Aim To investigage the association of fibroblast growth factor 23 （FGF23） with carotid atherosclero- sis in patients with moderate and advanced stage chronic kidney disease （CKD）. Methods Serum intact FGF23 lev- els in 120 patients with CKD stage 3 to 5 and 20 age and sex-matched healthy controls were measured by enzyme-linked im- munosorbent assay （ELISA）. There were 3ff non dialysis patients, 30 peritoneal dialysis patients and 60 hemodialysis pa- tients. The difference between non dialysis group, peritoneal dialysis group and hemodialysis group was compared, too. The patients with moderate and advanced stage CKD were divided into atherosclerosis group and no atherosclerosis group, which clinical parameters and level of FGF23 were compared. The association between FGF23 and carotid atherosclerosis was studied. Results The incidence of carotid atherosclerosis in patients with moderate and advanced stage CKD was relatively high （59/120, 49. 2% ）. The levels of serum FGF23 in atherosclerosis group were significantly higher than no atherosclerosis group （P 〈 O. O1 ）. The serum levels of FGF23 in patients were significantly higher than those in the healthy controls （P 〈 0. 01 ）. The levels of FGF23 were higher in dialyzed patients than those in non-dialyzed patients （P 〈 0. 05）,and hemodialysis patients had significantly higher levels as compared to peritoneal dialysis ones （ P 〈 0. 11 ）. Serum FGF23 level was positively correlated with carotid artery intima-media thickness （ r = 0.68, P 〈0. 05 ）. In multivariate regression analysis, high FGF23 concentration was a significant independent risk factor of carotid artery atherosclerosis in patients with moderate and advanced stage CKD. Conclusions Serum FGF23 level was correlated with carotid athero- sclerosis in patients with moderate and advanced stage CKD. FGF23 may play an important role in occurrence and devel- opment of carotid atherosclerosis. FGF23 may be one of the more sensitive markers to predict the occurrence of

关 键 词：成纤维细胞生长因子23 颈动脉粥样硬化 中晚期慢性肾脏病 

分 类 号：R5[医药卫生—内科学]