成纤维细胞因子23对急性肾损伤的诊断价值研究  

Diagnostic value of fibroblast growth factor 23 in acute kidney injury

作　　者：高小娟 张建芳 李媛媛 王乐 赵雪敏 韩继斌 GAO Xiaojuan;ZHANG Jianfang;LI Yuanyuan;WANG Le;ZHAO Xuemin;HAN Jibin(The First Clinical Medical College,Shanxi Medical University,Taiyuan,Shanxi 030001,China;School of Public Health,Shanxi Medical University,Taiyuan,Shanxi 030001,China;Department of Critical Care Medicine,The First Hospital of Shanxi Medical University,Taiyuan,Shanxi 030001,China;Medical Department,Taiyuan Psychiatric Hospital,Taiyuan,Shanxi 030045,China)

机构地区：[1]山西医科大学第一临床医学院,山西太原030001 [2]山西医科大学公共卫生学院,山西太原030001 [3]山西医科大第一医院重症医学科,山西太原030001 [4]太原市精神病医院医务科,山西太原030045

出　　处：《安徽医药》2024年第7期1387-1391,共5页Anhui Medical and Pharmaceutical Journal

基　　金：山西省应用基础研究项目(201801D221417)。

摘　　要：目的探究成纤维细胞因子23(FGF23)对急性肾损伤(AKI)的诊断价值。方法选取2022年2—7月山西医科大学第一医院重症医学科收治的105例AKI病人(AKI组)和203例非AKI病人(非AKI组)为研究对象,检测两组病人的血浆FGF23水平,并将AKI组病人根据改善全球肾脏病预后组织(KDIGO)标准分期进行亚组分析;采用Spearman相关性分析法分析FGF23浓度与各指标间的相关性;采用多因素logistic回归分析法分析AKI的危险因素;绘制受试者操作特征曲线(ROC曲线),计算曲线下面积(AUC),探究血浆FGF23水平对AKI的诊断效能。结果两组病人在年龄、身体质量指数(BMI)方面均差异无统计学意义(P>0.05);与非AKI组病人相比,AKI组的ICU住院时间、总住院时间较高(P<0.001);AKI组病人在急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)、血清肌酐、尿素、血浆FGF23水平[27(20,32)分、179(108.10,293.90)µmol/L、14.70(9.54,21.22)mmol/L、169.83(164.83,174.83)ng/L]等方面均高于非AKI组[16(12,21)分、61(48.10,77.80)µmol/L、5.53(4.03,8.05)mmol/L、139.83(124.83,156.50)ng/L](P<0.001);AKI组的肾小球滤过率、尿量均低于非AKI组(P<0.001);AKI不同分期血浆FGF23水平随分期的递增而逐渐升高(P<0.05),且1和3期、2和3期组间比较差异有统计学意义(P<0.05);Scr浓度、FGF23水平是AKI的独立危险因素;FGF23用于诊断AKI的灵敏度(87.6%)高于Scr,其特异度(90.6%)与Scr相差不大。结论FGF23是AKI的独立危险因素,对AKI有较高的诊断价值。Objective To explore the diagnostic value of fibroblast growth factor 23(FGF23)in acute kidney injury(AKI).Methods A total of 105 AKI patients(AKI group)and 203 non-AKI patients(non-AKI group)admitted to the Department of Critical Care Medi-cine of the First Hospital of Shanxi Medical University from February 2022 to July 2022 were selected as the research objects.Plasma FGF23 levels were measured in the two groups,and the AKI patients were divided into subgroups according to Kidney Disease:Improv-ing Global Outcomes(KDIGO)staging criteria.Correlations between FGF23 concentrations and each index were analyzed by Spear-man's correlation.Multivariate Logistic regression analysis was used to analyze the risk factors of AKI.The receiver operating charac-teristic curve was drawn and the area under the curve(AUC)was calculated to explore the diagnostic efficacy of plasma FGF23 level for AKI.Results There were no significant differences in age and body mass index(BMI)between the two groups(P>0.05).Compared with the non-AKI group patients,the AKI group had higher ICU length of stay and total hospital length of stay,which were statistically significant(P<0.001).APACHEⅡscore,creatinine,urea and plasma FGF23 levels[27(20,32)points,179(108.10,293.90)µmol/L,14.70(9.54,21.22)mmol/L,169.83(164.83,174.83)ng/L]in AKI group were higher than those in non-AKI group[16(12,21)points,61(48.10,77.80)µmol/L,5.53(4.03,8.05)mmol/L,139.83(124.83,156.50)ng/L],and the differences were statistically significant(P<0.001).The glomerular filtration rate and urine volume in AKI group were lower than those in non-AKI group(P<0.001).The level of plasma FGF23 in different stages of AKI increased gradually with increasing AKI stages(P<0.01),and the difference between the two groups in stages 1 and 3,stages 2 and 3 were statistically significant(P<0.05).Scr concentration and FGF23 level were independent risk factors for AKI.The sensitivity of FGF23 in the diagnosis of AKI(87.6%)was higher than that of Scr,and its specificity(90.6%)was similar to th

关 键 词：急性肾损伤 成纤维细胞因子23 生物标志物 肾功能 诊断价值 

分 类 号：R692[医药卫生—泌尿科学]