血清成纤维细胞生长因子23在桡动脉钙化及动静脉内瘘失功中的预测作用  

Serum fibroblast growth factor-23(FGF-23)level for predicting radial artery calcification and arteriovenous fistula dysfunction in hemodialysis patients

作　　者：张志坚[1] 陈涵枝[1] 刘斌[1] 刘晓斌[1] 陈勇[1] 常艳华[1] 单炜薇[1] 王凉[1] 孙铸兴[1] ZHANG Zhi-jian;CHEN Han-zhi;LIU Bin;LIU Xiao-bin;CHEN Yong;CHANG Yan-hua;SHAN Wei-wei;WANG Liang;SUN Zhu-xing(Department of Nephrology,Wuxi People’s Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China)

机构地区：[1]南京医科大学附属无锡市人民医院肾内科,无锡214023

出　　处：《中国血液净化》2021年第6期410-414,共5页Chinese Journal of Blood Purification

基　　金：南京医科大学科技发展基金重点项目(2017NJMUZD124)。

摘　　要：目的探讨成纤维细胞生长因子23(fibroblast growth factor-23,FGF-23)水平在终末期肾病(end stage renal disease,ESRD)患者桡动脉钙化(radial artery calcification,RAC)与自体动静脉内瘘(arteriovenous fistula,AVF)失功中的预测价值。方法收集212例在南京医科大学附属无锡市人民医院行AVF手术的ESRD患者的临床资料,采用ELISA检测患者术前血清FGF-23水平。采用HE染色法对桡动脉血管进行钙化染色以评估RAC程度。据随访期间临床及影像学资料将患者分为AVF失功及AVF通畅组。比较FGF-23水平在不同分组中的差异及预测作用。结果212例患者中有57.8%发生RAC(123/212)。当cut-off值取FGF-23>488.5ng/ml时,FGF-23预测RAC的敏感性为0.797,特异性为0.921;当cut-off值取FGF-23>490.9ng/ml时,预测AVF失功的敏感性为0.757,特异性为0.560。结论ESRD患者RAC的发生率高,FGF-23可能是预测RAC及AVF失功的理想标志物。Objective To investigate the relationship between serum fibroblast growth factor-23(FGF-23)level and radial artery calcification(RAC)and arteriovenous fistula(AVF)dysfunction in hemodialysis patients.Methods This prospective study included 212 maintenance hemodialysis(MHD)patients undergoing AVF surgery.Serum FGF-23 level was measured by ELISA.Clinical and biochemical data were collected.RAC was assayed by hematoxylin-eosin staining.Serum FGF-23 levels were compared between patient groups,and the prediction effect of serum FGF-23 level was then evaluated.Results The prevalence of RAC was 57.8%(123/212)in the MHD patients.When the cut-off value of serum FGF-23 level was set at488.5 ng/ml,the sensitivity and specificity for the diagnosis of RAC were 0.797 and 0.921 respectively.When the cut-off value of serum FGF-23 level was set at 490.9 ng/ml,the sensitivity and specificity for the diagnosis of AVF dysfunction were 0.757 and 0.560 respectively.Conclusion Higher prevalence of RAC was found in end-stage renal disease patients.Serum FGF-23 appears to be a sensitive and specific marker of RAC and AVF dysfunction in hemodialysis patients.

关 键 词：血液透析 桡动脉钙化 动静脉内瘘 成纤维细胞生长因子23 

分 类 号：R318.16[医药卫生—生物医学工程]