机构地区:[1]西安交通大学医学院附属三二〇一医院,西安723000
出 处:《山东医药》2019年第13期27-30,共4页Shandong Medical Journal
基 金:陕西省自然科学基础研究计划项目(2015JM6105)
摘 要:目的探讨血清成纤维生长因子23(FGF-23)、可溶性klotho蛋白(sKL)检测对持续非卧床腹膜透析(CAPD)患者心脏瓣膜钙化的预测价值。方法选择CAPD> 3个月的患者109例,根据心脏彩色超声检查的心脏瓣膜钙化情况将其分为瓣膜钙化组51例、瓣膜正常组58例,同期选取30例体检健康者为对照组。采用酶联免疫吸附法检测各组血清FGF-23、sKL水平,采用Logistic回归分析CAPD患者心脏瓣膜钙化的影响因素,用受试者工作特征曲线下面积(AUC)评估血清FGF-23、sKL对心脏瓣膜钙化的预测价值。结果瓣膜钙化组、瓣膜正常组血磷、碱性磷酸酶(ALP)、血钙、血清肌酐(SCr)水平高于对照组(P均<0. 05),总尿素清除指数(Kt/V)低于对照组(P <0. 05);瓣膜钙化组透析龄、血磷、ALP、血钙、SCr、FGF-23水平高于瓣膜正常组(P均<0. 05),Kt/V、血清sKL水平低于瓣膜正常组(P均<0. 05)。血磷、血清FGF-23水平升高是CAPD患者心脏瓣膜钙化的独立危险因素(OR分别为1. 995、2. 328,P均<0. 05),血清sKL水平升高是CAPD患者心脏瓣膜钙化的保护因素(OR=0. 742,P均<0. 05)。血清FGF-23、sKL预测心脏瓣膜钙化的AUC分别为0. 844、0. 814,二者联合检测预测心脏瓣膜钙化的AUC为0. 941。结论血清FGF-23、sKL是CAPD患者发生心脏瓣膜钙化的影响因素,二者联合检测对CAPD患者发生心脏瓣膜钙化的预测价值较高。Objective To investigate the predictive value of serum fibroblast growth factor 23(FGF-23)and soluble Klotho protein(sKL)in cardiac valve calcification in patients undergoing continuous ambulatory peritoneal dialysis(CAPD).Methods Totally 109 patients with CAPD>3 months were selected.According to the condition of cardiac valve calcification examined by color Doppler echocardiography,they were divided into the valvular calcification group of 51 cases and the normal valves group of 58 cases.At the same time,30 healthy persons were selected as the control group.The general information of each group was collected,the serum levels of FGF-23 and sKL were measured by ELISA.Logistic regression was used to analyze the influencing factors for cardiac valve calcification in CAPD patients.The predictive value of serum FGF-23 and sKL on cardiac valve calcification was evaluated by the area under the working characteristic curve(AUC).Results The levels of serum phosphorus,ALP,serum calcium and SCr in the valvular calcification group and normal valves group were higher than those in the control group(all P<0.05),but Kt/V was lower(P<0.05).The dialysis age,serum phosphorus,ALP,serum calcium,SCr,and FGF-23 levels in the valvular calcification group were higher than those in the normal valves group(all P<0.05),while the levels of Kt/V and sKL were lower than those in the normal valves group(both P<0.05).The elevated level of serum phosphorus and serum FGF-23 were independent risk factors for cardiac valve calcification in the CAPD patients(OR=1.995 and 2.328,respectively,all P<0.05).The elevated level of sKL was a protective factor for cardiac valve calcification in CAPD patients(OR=0.742,all P<0.05).The AUC of serum FGF-23 and sKL in predicting cardiac valve calcification was 0.844 and 0.814,respectively,and the AUC of combined detection of them in predicting cardiac valve calcification was 0.941.Conclusion Serum FGF-23 and sKL are the influencing factors of cardiac valve calcification in CAPD patients,and the combined detection
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