维持性血液透析患者血清FGF23、D-ser水平与听力障碍的相关性研究  

Study on the correlation between serum FGF23 and D-ser levels and hearing impairment in maintenance hemodialysis patients

作　　者：杨振昊 范伟峰 吴青 张丽红 余莹 杨麟 牛建英 Yang Zhenhao;Fan Weifeng;Wu Qing;Zhang Lihong;Yu Ying;Yang Lin;Niu Jianying(Department of Nephrology,Fudan University Affiliated Shanghai Fifth People's Hospital,Shanghai 200240,China;不详)

机构地区：[1]复旦大学附属上海市第五人民医院肾内科,上海200240 [2]国家老年疾病临床医学研究中心,上海

出　　处：《疑难病杂志》2024年第8期950-954,960,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：上海市科学技术委员会科研项目计划(202140316)。

摘　　要：目的探讨维持性血液透析(MHD)患者血清成纤维细胞生长因子23(FGF23)、D-丝氨酸(D-ser)水平与听力障碍的相关性。方法选取2021年1月—2023年12月复旦大学附属上海市第五人民医院肾内科收治MHD患者80例,其中合并听力障碍40例作为听力障碍组,未合并听力障碍40例为非听力障碍组,同期医院体检健康者40例为健康对照组;采用酶联免疫吸附法与高效液相色谱荧光法检测血清FGF23与D-ser水平;通过Spearman/Pearson相关系数分析MHD患者血清FGF23、D-ser水平与平均听阈(PTA)的相关性,多因素Logistic回归分析MHD患者听力障碍的影响因素,ROC曲线分析血清FGF23、D-ser水平对MHD患者听力障碍的预测价值。结果血清FGF23、D-ser水平比较,听力障碍组>非听力障碍组>健康对照组(F/P=69.767/<0.001、307.552/<0.001);Spearman/Pearson相关性显示,MHD患者血清FGF23、D-ser水平与PTA呈正相关(r_(s)/P=0.649/<0.001、0.669/<0.001)。多因素Logistic回归分析显示,透析龄长、FGF23高、D-ser高为MHD患者听力障碍的独立危险因素[OR(95%CI)=1.036(1.007~1.065)、1.018(1.006~1.029)、1.526(1.145~2.033)];ROC曲线显示,血清FGF23、D-ser水平及二者联合预测MHD患者听力障碍的曲线下面积(AUC)分别为0.773、0.788、0.880,二者联合大于二者各自单独预测(Z/P=2.409/0.016、2.344/0.019)。结论MHD患者血清FGF23、D-ser水平升高是听力障碍的独立危险因素,二者联合预测MHD患者听力障碍的价值较高。Objective To investigate the correlation between serum fibroblast growth factor 23(FGF23)and D-serine(D-ser)levels and hearing impairment in maintenance hemodialysis(MHD)patients.Methods Forty MHD patients with combined hearing impairment admitted to the Department of Nephrology of Shanghai Fifth People's Hospital Affiliated to Fudan University from January 2021 to December 2023 were selected as the hearing-impaired group,40 MHD patients without combined hearing impairment were selected as the non-hearing-impaired group,and 40 healthy patients with physical examination were selected as the healthy control group;Serum FGF23 and D-ser levels were measured by enzyme-linked immunosorbent assay with high performance liquid chromatography fluorescence;The correlation between serum FGF23 and D-ser levels and PTA in MHD patients was analyzed by Spearman/Pearson correlation coefficients,the factors of hearing impairment in MHD patients were analyzed by multifactorial logistic regression,and the predictive value of serum FGF23 and D-ser levels for hearing impairment in MHD patients was analyzed by ROC curves.Results Serum FGF23 and D-ser levels were higher in the hearing-impaired group than in the non-hearing-impaired group and the control group,and serum FGF23 and D-ser levels were higher in the non-hearing-impaired group than in the control group(F/P=69.767/<0.001,307.552/0.001).Spearman/Pearson correlation showed a positive correlation between serum FGF23 and D-ser levels and PTA in patients with MHD(r_(s)/P=0.649/<0.001,0.669/<0.001).Multifactorial logistic regression showed that prolonged dialysis age,elevated FGF23,and elevated D-ser were independent risk factors for hearing impairment in MHD patients[OR(95%CI)=1.036(1.007-1.065),1.018(1.006-1.029),and 1.526(1.145-2.033)];The ROC curves showed that the area under the curve(AUC)of serum FGF23,D-ser levels and the combination of the two predicted hearing impairment in MHD patients were 0.773,0.788,0.880,respectively,and that the combination of the two was greater than

关 键 词：维持性血液透析 听力障碍 成纤维细胞生长因子23 D-丝氨酸 预测价值 

分 类 号：R692.5[医药卫生—泌尿科学]