尿毒症血液透析患者血清Lp-PLA2、FGF-23与自体动静脉内瘘成熟不良的关系研究  

Study on the Relationship between Serum Lp-PLA2,FGF-23 and Poor Maturation of Autologous Arteriovenous Fistula in Uremic Hemodialysis Patients

作　　者：余燕燕 左君秋 周红霞 邹鑫 刘秀娟 YU Yan-yan;ZUO Jun-qiu;ZHOU Hong-xia;ZOU Xin;LIU Xiu-juan(Department of Nephrology,908 Hospital of Joint Logistics Support Force,Nanchang,Jiangxi,330000,China)

机构地区：[1]联勤保障部队第九〇八医院肾脏内科,江西南昌330000

出　　处：《现代生物医学进展》2024年第3期512-516,共5页Progress in Modern Biomedicine

基　　金：江西省卫生健康委科技计划项目(202131118)。

摘　　要：目的:探讨尿毒症血液透析患者血清脂蛋白相关磷脂酶A2(Lp-PLA2)、成纤维细胞生长因子-23(FGF-23)与自体动静脉内瘘(AVF)成熟不良的关系。方法:选取2021年2月~2022年12月联勤保障部队第908医院肾内科收治的170例接受血液透析的尿毒症患者,根据AVF成熟情况分为成熟不良组57例和成熟组113例。采用酶联免疫吸附法检测血清Lp-PLA2、FGF-23水平。通过多因素Logistic回归分析尿毒症血液透析患者AVF成熟不良的影响因素,受试者工作特征(ROC)曲线分析血清Lp-PLA2、FGF-23水平对尿毒症血液透析患者AVF成熟不良的预测效能。结果:成熟不良组血清Lp-PLA2、FGF-23水平高于成熟组(P<0.05)。多因素Logistic回归分析显示,血磷、低密度脂蛋白胆固醇(LDL-C)、Lp-PLA2、FGF-23升高为尿毒症血液透析患者AVF成熟不良的独立危险因素(P<0.05)。ROC曲线分析显示,血清Lp-PLA2、FGF-23水平单独和联合预测尿毒症血液透析患者AVF成熟不良的曲线下面积(AUC)分别为0.725、0.763、0.822,血清Lp-PLA2、FGF-23水平联合预测的AUC最大。结论:尿毒症血液透析患者血清Lp-PLA2、FGF-23水平升高与AVF成熟不良独立相关,血清Lp-PLA2、FGF-23水平联合对AVF成熟不良的预测效能良好。Objective:To investigate the relationship between serum lipoprotein-associated phospholipase A2(Lp-PLA2),fibroblast growth factor-23(FGF-23)and poor maturation of autologous arteriovenous fistula(AVF)in uremic hemodialysis patients.Methods:170 uremia patients who were received hemodialysis in the Nephrology Department of 908 Hospital of Joint Logistics Support Force from February 2021 to December 2022 were selected,patients were divided into 57 cases of poor maturity group and 113 cases of maturity group according to the maturity of AVF.Serum Lp-PLA2 and FGF-23 levels were detected by enzyme-linked immunosorbent assay.The influencing factors of poor AVF maturation in uremic hemodialysis patients were analyzed by multivariate Logistic regression.The predictive efficacy of serum Lp-PLA2 and FGF-23 levels on poor AVF maturation in uremic hemodialysis patients were analyzed by receiver operating characteristic(ROC)curve.Results:The levels of serum Lp-PLA2 and FGF-23 in poor maturity group were higher than those in maturity group(P<0.05).Multivariate Logistic regression analysis showed that,increased serum phosphorus,low-density lipoprotein cholesterol(LDL-C),Lp-PLA2 and FGF-23 were independent risk factors for poor AVF maturation in uremic hemodialysis patients(P<0.05).ROC curve analysis showed that,the area under the curve(AUC)of serum Lp-PLA2 and FGF-23 levels alone and in combination to predict poor AVF maturation in uremic hemodialysis patients was 0.725,0.763 and 0.822 respectively,and the AUC of serum Lp-PLA2 and FGF-23 levels combined prediction was the largest.Conclusion:The increase of serum Lp-PLA2 and FGF-23 levels in uremic hemodialysis patients were independently relate to the poor maturation of AVF,the combination of serum Lp-PLA2 and FGF-23 levels had a good predictive effect on the poor maturation of AVF.

关 键 词：尿毒症 血液透析 脂蛋白相关磷脂酶A2 成纤维细胞生长因子-23 自体动静脉内瘘 

分 类 号：R692[医药卫生—泌尿科学]