FGF23、Klotho蛋白及Lp-PLA2水平与血液透析患者微炎症状态、钙磷代谢紊乱的关系分析  

Analysis of relationship between levels of FGF23,Klotho protein and Lp-PLA2 and micro-inflammatory status and calcium-phosphorus metabolism disorder in patients undergoing hemodialysis

作　　者：牟洪宾[1] 周刚[1] 赵传燕 陈蕊[1] 毕光宇[1] 刘昌华[1] 高波[1] 徐军[1] Mou Hong-bin;Zhou Gang;Zhao Chuan-yan;Chen Rui;Bi Guang-yu;Liu Chang-hua;Gao Bo;Xu Jun(Jiangsu Subei People's Hospital,Department of Nephrology,Yangzhou 225001,China)

机构地区：[1]江苏省苏北人民医院肾脏内科,扬州225001

出　　处：《湖南师范大学学报（医学版）》2022年第1期224-227,共4页Journal of Hunan Normal University(Medical Sciences)

摘　　要：目的:分析成纤维细胞生长因子23(FGF23)、Klotho蛋白及脂蛋白相关磷脂酶A2(Lp-PLA2)水平与血液透析患者微炎症状态、钙磷代谢紊乱的关系。方法:收集我院312例行维持性血液透析(MHD)患者临床资料,分别根据C反应蛋白(CRP)将其分为微炎症组(CRP≥8mg/L)及非微炎症组(CRP<8mg/L),根据美国肾脏基金会对肾脏病生存质量指导(KDOQI)指南中终末期肾脏病患者总血钙及血磷靶目标值分为非钙磷代谢紊乱组(2.10mmol/L≤总血钙≤2.50mmol/L且1.13mmol/L≤血磷≤1.78mmol/L)及钙磷代谢紊乱组(未达靶目标值),分别比较各组血清FGF23、Klotho蛋白及Lp-PLA2水平,并采用Pearson相关系数分析MHD患者血清FGF23、Klotho蛋白、Lp-PLA2水平与CRP、总血钙、血磷的相关性。结果:微炎症组血清FGF23、Lp-PLA2水平均高于非微炎症组,Klotho蛋白则低于非微炎症组。钙磷代谢紊乱组血清FGF23、Lp-PLA2水平均高于非钙磷代谢紊乱组,Klotho蛋白则低于非钙磷代谢紊乱组。Pearson相关系数显示,MHD患者血清FGF23、Klotho蛋白、Lp-PLA2水平与总血钙无明显相关性,血清FGF23、Lp-PLA2水平与CRP及血磷呈显著正相关,Klotho蛋白与CRP及血磷呈显著负相关。结论:血清FGF23、Klotho蛋白、Lp-PLA2水平与MHD患者钙磷代谢紊乱及微炎症状态密切相关,可作为指导MHD诊疗的新指标。Objective To analyze the relationship between levels of fibroblast growth factor 23(FGF23),Klotho protein and lipoprotein-associated phospholipase A2(Lp-PLA2) and micro-inflammatory status and calcium-phosphorus metabolism disorder in patients with hemodialysis.Methods The clinical data of 312 patients undergoing maintenance hemodialysis (MHD) in the hospital were collected,and the patients were divided into microinflammation group (CRP≥8mg/L) and non-microinflammation group (CRP<8mg/L) according to C-reactive protein (CRP),and were classified into non-calcium-phosphorus metabolism disorder group (2.10mmol/L≤total blood calcium≤2.50mmol/L,1.13mmol/L≤blood phosphorus ≤1.78mmol/L) and calcium-phosphorus metabolism disorder group (not reaching the target values) according to the target values of total blood calcium and blood phosphorus in patients with end-stage renal disease in Kidney Disease Outcomes Quality Initiative (KDOQI).The levels of serum FGF23,Klotho protein and Lp-PLA2 were compared between the groups,and Pearson correlation coefficient was used to analyze the correlation between levels of serum FGF23,Klotho protein and Lp-PLA2 and CRP,total blood calcium and blood phosphorus in patients with MHD.Results The levels of serum FGF23 and Lp-PLA2 in microinflammation group were higher than those in non-microinflammation group while the Klotho protein was lower than that in non-microinflammation group.The levels of serum FGF23 and Lp-PLA2 in calcium-phosphorus metabolism disorder group were higher than those in non-calcium-phosphorus metabolism disorder group while the Klotho protein was lower than that in non-calcium-phosphorus metabolism disorder group.Pearson correlation coefficient showed that the levels of serum FGF23,Klotho protein and Lp-PLA2 in patients with MHD were not significantly correlated with total blood calcium,and the levels of serum FGF23 and Lp-PLA2 were significantly positively correlated with CRP and blood phosphorus,and Klotho protein was significantly negatively correlated wit

关 键 词：维持性血液透析 微炎症状态 钙磷代谢紊乱 FGF23 KLOTHO LP-PLA2 

分 类 号：R692.5[医药卫生—泌尿科学]