血清FGF23与腹膜透析病人主动脉弓钙化的相关性研究  

CORRELATION BETWEEN SERUM FIBROBLAST GROWTH FACTOR-23 LEVEL AND AORTIC ARCH CALCIFICATION IN CAPD PATIENTS

作　　者：许珊珊[1] 祁娇 孙安子 其其格[1] 王爱雪 赵建荣[1] XU Shan-shan;QI Jiao;SUN An-zi(Department of Nephrology,The Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050 China)

机构地区：[1]内蒙古医科大学附属医院肾内科,内蒙古呼和浩特010050

出　　处：《内蒙古医科大学学报》2021年第1期9-13,共5页Journal of Inner Mongolia Medical University

基　　金：内蒙古医科大学青年创新基金(YKD2017QNCX097)。

摘　　要：目的:探究血清FGF23水平与腹膜透析(PD)病人主动脉弓钙化的关联。方法:以2017-06~2019-10在笔者所在医院行持续非卧床腹膜透析>6个月的病人为研究对象,搜集临床资料,主动脉弓钙化情况采用胸部正侧位X线片来评价,血清FGF23及血清可溶性Klotho蛋白(sKL)浓度的检测采用ELISA法。PD病人发生主动脉弓钙化的危险因素采用Logistic回归分析,血清FGF23及sKL预测主动脉弓钙化的准确性、特异性采用受试者工作特征曲线(ROC)进行评价。结果:在72例PD病人中,发生主动脉钙化的病人有39例,占54.20%。PD病人发生主动脉弓钙化与FGF-23、透析龄、血肌酐、磷、校正钙、ALP、iPTH呈正相关(P=0.011,0.007,0.008,0.047,0.028,0.017,0.006),与sKL、Kt/V、RRF呈负相关(P=0.015,0.006,0.003)。多因素Logistic回归分析提示,高水平FGF-23(P=0.012)、高水平血磷(P=0.031)、低水平sKL(P=0.015)是PD病人发生主动脉弓钙化的独立危险因素。ROC曲线提示,FGF-23及sKL预测主动脉弓钙化的灵敏度分别为71.4%、84.2%,特异度分别为94.7%、81.0%。结论:高水平FGF-23和低水平sKL是PD病人主动脉弓钙化的独立危险因素,两者对PD病人主动脉弓钙化诊断的准确性均较高。Objective:To explore the relationship between fibroblast growth factor-23(FGF-23)and aortic arch calcification in patients with peritoneal dialysis(PD).Methods:From June 2017 to october 2019,72 continuous ambulatory peritoneal dialysis(CAPD)patients in our hospital were selected as the research object.Their clinical indexes were analyzed,aortic arch calcification was evaluated by chest X-ray.The levels of serum fibroblast growth factor23(FGF23)and soluble klotho(sKL)were detected by ELISA.Logistic regression analysis was used to determine the risk factor of aortic arch calcification in PD patients.The receiver operator characteristic curves(ROC)analysis was applied to evaluate the sensitivity and specificity of fibroblast growth factor23(FGF23)and sKL in aortic arch calcification.Results:Among 72 PD patients,39 patients had aortic calcification,the incidence was 54.20%.The risk of aortic arch calcification indicated positive correlation with the level of FGF-23,dialysis age,serum creatinine,serum phosphorus,corrected calcium,serum alkaline phosphatase,parathyroid hormone(P=0.011,0.007,0.008,0.047,0.028,0.017,0.006),and it has negative correlation with the level of sKL,urea clearance index,and residual renal function(P=0.015,0.006,0.003).Logistic regression analysis indicated that the increase of FGF-23(P=0.012)and serum phosphorus(P=0.031)were two independent risk factors for aortic arch calcification in PD patients,and the decrease of sKL(P=0.015)was another independent risk factor.The ROC indicated that the sensitivity of FGF-23 and sKL were 71.4%and 84.2%,and the specificity were 94.7%and 81.0%,respectively.Conclusion:The increase of FGF-23 and decrease of sKL are two independent risk factors for aortic arch calcification in PD patients.FGF-23 and sKL had high accuracy in the diagnosis of aortic arch calcification in PD patients.

关 键 词：血清FGF-23 可溶性klotho蛋白 腹膜透析 主动脉钙化 

分 类 号：R543.12[医药卫生—心血管疾病]