维持性血液透析患者血清Klotho蛋白水平及其影响因素  

Level and influential factors of serum Klotho in maintenance hemodialysis patients

作　　者：贾艳丽[1] 王英[1] 程浩[1] 孙懿[1] 

机构地区：[1]首都医科大学附属复兴医院肾内科,北京100038

出　　处：《临床荟萃》2015年第8期928-931,共4页Clinical Focus

摘　　要：目的探讨维持性血液透析(MHD)患者血清Klotho蛋白水平及影响因素。方法选择本院病情稳定的MHD患者46例,年龄匹配的健康体检者10例作为对照组。采用酶联免疫吸附技术测定血清Klotho蛋白水平;检测血清成纤维细胞生长因子23(FGF23)、全段甲状旁腺激素(iPTH)、血钙、血磷、白蛋白(Alb)、血色素(Hb)、肌酐(SCr)、尿素氮(BUN)等指标,收集并计算患者平均每日元素钙和活性维生素D摄入量。结果 MHD组血清Klotho蛋白水平为(283.3±219.1)ng/L,明显低于对照组(1 125.5±127.0)ng/L(P<0.01)。pearson相关分析显示,Klotho蛋白水平与FGF23(r=-0.929,P<0.01)、SCr(r=-0.393,P<0.01)、BUN(r=-0.429,P<0.01)、血钙(r=-0.325,P<0.05)、血磷(r=-0.687,P<0.01)、平均每日元素钙摄入量(r=-0.411,P<0.01)和平均每日活性维生素D摄入量(r=-0.354,P<0.05)呈负相关。多元逐步回归分析显示FGF23是血清Klotho蛋白水平的影响因素。结论血液透析患者血清Klotho蛋白水平明显降低,血清FGF23是影响血清Klotho蛋白水平的因素。Objective To explore the level and influential factors of serum Klotho in maintenance hemodialysis （MHD） patients. Methods A total of 46 MHD patients in a stable condition were enrolled in this study. In addition, 10 age-matched healthy people were selected as control. The serum Klotho was measured by enzyme linked immunosorbent assay technology. The levels of serum fibroblast growth factor 23 （FGF23）, intact parathyroid hormone （iPTH）, serum calcium, serum phosphorus, albumin, hemoglobin, renal function and other indicators were detected. The average daily intake of element calcium and activated vitamin D were collected and calculated. Results The serum Klotho was significantly lower in hemodialysis patients than in control group （283.26 ± 219.06 ng/L vs 1 125.50 ± 126.96 ng/L, P d0.01）. Pearson correlation analysis showed that there were negative correlation between Log Klotho and Log FGF23 （ r =-0. 929, P 〈0.01）, serum creatinine （ r =-0. 393, P d0.01）, urea nitrogen （ r = -0. 429, P d0.01）, serum calcium （ r = -0. 325, P 〈0.05）, serum phosphorus （ r = -0. 687, P d0.01）, the average daily calcium intake （ r = -0. 411, P 〈0.01） and the average daily active vitamin D intake （ r = -0. 354, P 〈0.05）. Multiple stepwise regression analysis showed that the influence factor of serum Klotho was FGF23. Conclusion The serum level of Klotho in hemodialysis patients decreased significantly and its key influential factor was the serum FGF23.

关 键 词：肾透析 成纤维细胞生长因子 KLOTHO 

分 类 号：R459.5[医药卫生—治疗学]