慢性肾衰竭患者血清成纤维生长因子-23水平与血管病变的关系探讨  

The relationship between serum FGF-23 level and vascular lesions in patients with chronic renal failure

作　　者：苏东美 朱雪丽 马金燕 李莎[1] 温月[1] 罗燕[1] SU Dong-mei;ZHU Xue-li;MA Jin-yan;LI Sha;WEN Yue;LUO Yan(Department of Nephrology,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院肾脏内科,四川成都610041

出　　处：《实用医院临床杂志》2022年第6期92-95,共4页Practical Journal of Clinical Medicine

摘　　要：目的 分析血清成纤维生长因子-23(FGF-23)水平与慢性肾衰竭血管病变、预后的关系。方法 将我院收治的136例慢性肾衰竭患者根据是否发生血管病变分为病变组(n=29)和非病变组(n=107)。记录患者一般临床资料、生化指标、血常规指标及FGF-23。结果 病变组甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、红细胞压积(HCT)、前清蛋白(PA)、血清白蛋白(Alb)、组织因子(TF)、总胆固醇(TC)、FGF-23评分均低于非病变组(P<0.05)。血清FGF-23与TG、HDL-C、HCT、PA、Alb、TF、TC呈负相关(P<0.001)。TG、HDL-C、HCT、PA、Alb、TF、TC均为FGF-23的保护性因素(P<0.001)。以血清FGF-23水平的表达对患者血管病变及预后的预测价值,灵敏度为86.4%,特异度为82.3%,AUC为0.882,约登指数为0.687。采用Hosmer-Lemeshow进行一致性评价,校准度和一致性较好。结论 血清FGF-23水平与CRF患者血管病变密切相关,且此项水平异常可能导致患者预后不佳,临床评估患者血清FGF-23水平,预测血管病变具有较高价值。Objective To analyze the relationship between the serum fibroblast growth factor-23(FGF-23) level and the vascular disease and prognosis of chronic renal failure(CRF).Methods One hundred and thirty-six patients with CRF admitted to our hospital were divided into a lesion group(n=29) and a non-lesion group(n=107) according to the occurrence of vascular lesions. The general clinical data, biochemical indexes, blood routine indexes and FGF-23 of the patients were recorded.Results The scores of triglyceride(TG), high density lipoprotein cholesterol(HDL-C), hematocrit(HCT), prealbumin(PA), serum albumin(Alb), tissue factor(TF), total cholesterol(TC) and FGF-23 in the lesion group were lower than those in the non-lesion group(P<0.05). Serum FGF-23 was negatively correlated with TG, HDL-C, HCT, PA, Alb, TF and TC(P<0.001). TG, HDL-C, HCT, PA, Alb, TF and TC were protective factors of FGF-23(P<0.001). The sensitivity was 86.4%, the specificity was 82.3%, the area under the ROC curve(AUC) was 0.882, and the Youden index was 0.687 for the predictive value of serum FGF-23 expression in patients with vascular lesions and prognosis. Hosmer-Lemeshow was used for consistency evaluation, and the calibration degree and consistency were good.Conclusions Serum FGF-23 level is closely related to vascular disease in patients with CRF. The abnormalities in this factor may lead to a poor prognosis. Clinical evaluation of serum FGF-23 level in patients has a high value in predicting vascular disease.

关 键 词：血清成纤维生长因子-23 慢性肾衰竭 血管病变 预后 

分 类 号：R334.1[医药卫生—人体生理学]