慢性肾衰竭血液透析患者IL-13、FGF23、SOST水平变化与血管钙化的关系  

Changes of serum levels of interleukin-13,fibroblast growth factor 23 and sclerostin in patients with chronic renal failure undergoing hemodialysis and their relationship with vascular calcification

作　　者：罗静[1] 王琰[1] 张瑞[1] 刘敏[1] 李晓莹 LUO Jing;WANG Yan;ZHANG Rui;LIU Min;LI Xiaoying(Department of Nephrology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院肾内科,郑州450000

出　　处：《西南医科大学学报》2024年第4期325-329,共5页Journal of Southwest Medical University

基　　金：河南省科技发展计划项目(202102310226)。

摘　　要：目的分析慢性肾衰竭(chronic renalfailure,CRF)血液透析患者血清白介素13(interleukin-13,IL-13)、成纤维细胞生长因子23(fibroblast growthfactor 23,FGF23)、骨硬化蛋白(sclerostin,SOST)水平变化与血管钙化的关系。方法纳入2021年1月至2022年12月郑州大学第一附属医院收治的126例行维持性血液透析(maintenance hemodialysis,MHD)的CRF患者临床资料,所有患者使用X线正位片及腹部平片观察血管钙化情况,采用Adragao钙化评分法,分为0分(无钙化)、1~3分(轻度钙化)、4~6分(中度钙化)、7~8分(重度钙化),使用受试者工作特征(receiver operatingcharacteristic,ROC)曲线评估血清IL-13、FGF23、SOST对患者血管钙化的诊断价值,并使用Pearson相关系数评估存在血管钙化者的血管钙化评分与血清IL-13、FGF23、SOST的相关性。结果行MHD治疗的CRF患者中,合并血管钙化者且有糖尿病患病史的比例高于无血管钙化者(P<0.05),血清IL-13、FGF23、SOST水平均高于无血管钙化者(P<0.05)。ROC曲线分析显示,血清IL-13、FGF23、SOST对MHD治疗的CRF患者血管钙化的诊断均具有价值(AUC_(IL-13)=0.827,P<0.05;AUC_(FGF2)=0.781,P<0.05;AUC_(SOST)=0.746,P<0.05),且3项联合诊断价值更高(AUC=0.906,P<0.05)。重度血管钙化者血清IL-13、FGF23、SOST水平显著高于中度钙化与轻度钙化者(P<0.05),中度钙化者高于轻度钙化者(P<0.05);Pearson相关系数分析显示,合并血管钙化患者的血管钙化评分与血清IL-13、FGF23、SOST均呈正相关(r_(IL-13)=0.532,P<0.05;r_(FGF23)=0.504,P<0.05;r_(SOST)=0.511,P<0.05)。结论IL-13、FGF23、SOST可能参与了MHD治疗的CRF患者血管钙化发生、发展过程,监测三者血清水平变化具有重要的临床诊疗价值。Objective To analyze the changes of serum interleukin-13(IL-13),fibroblast growth factor 23(FGF23)and sclerostin(SOST)levels and their relationship with vascular calcification in patients with chronic renal failure(CRF)undergoing he-modialysis.Methods The clinical data of 126 patients with CRF undergoing maintenance hemodialysis(MHD)admitted to the First Affiliated Hospital of Zhengzhou University from January 2021 to December 2022 were collected.All patients were observed for vascu-lar calcification by X-ray normotopia film and abdominal plain film.According to Adragao calcification score,the patients were divided into 0 points(no calcification),1~3 points(mild calcification),4~6 points(moderate calcification)and 7~8 points(severe calcifi-cation).The diagnostic value of serum IL-13,FGF23 and SOST on vascular calcification was evaluated by receiver operating character-istic(ROC)curve.Pearson correlation coefficient was used to evaluate the correlation between vascular calcification score and serum IL-13,FGF23 and SOST in patients with vascular calcification.Results Among the patients with CRF undergoing MHD,the proportion of diabetes mellitus history in patients with vascular calcification was higher than that in patients without vascular calcification(P<0.05),and the levels of serum IL-13,FGF23 and SOST were higher than those in patients without vascular calcification(P<0.05).ROC curve analysis showed that serum IL-13,FGF23 and SOST had diagnostic value on vascular calcification in patients with CRF un-dergoing MHD(AUC_(IL-13)=0.827,P<0.05;AUC_(FGF2)=0.781,P<0.05;AUC_(SOST)=0.746,P<0.05),and the combination of the three items had the highest diagnostic value(AUC=0.906,P<0.05).Serum levels of IL-13,FGF23 and SOST in patients with severe vas-cular calcification were significantly higher than those in patients with moderate calcification and patients with mild calcification(P<0.05),and the above levels in patients with moderate calcification were higher than those in patients with mild calcification(P<0.05).Pearson

关 键 词：慢性肾衰竭 维持性血液透析 血管钙化 血清白介素13 成纤维细胞生长因子23 骨硬化蛋白 

分 类 号：R692.2[医药卫生—泌尿科学]