尿毒症患者血清纤维生长因子23水平及临床意义
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摘要
目的探讨尿毒症患者血清纤维生长因子23(FGF23)水平及临床意义。方法选取2016年1月至2018年2月在我院治疗的尿毒症患者82例s(尿毒症组),同时选取健康志愿者90例作为对照组,检测两组血清FGF23、甲状旁腺素(i PTH)、钙(Ca)、磷(P)等指标,同时测定腰椎、股骨颈骨密度(BMD)。结果尿毒症组血清FGF23、i PTH和P水平分别为(270. 03±87. 48) ng/L、(42. 39±13. 20) pmol/L和(2. 14±0. 24) mmol/L,高于对照组,差异有统计学意义(P <0. 05); Ca和1,25羟维生素D3[1,25(OH)_2D_3]分别为(1. 80±0. 22) mmol/L和9. 89(1. 32,54. 39) ng/L,低于对照组,差异有统计学意义(P<0. 05);尿毒症组股骨颈和腰椎BMD水平分别为(0. 71±0. 12) g/m~2和(0. 67±0. 14) g/m~2,低于对照组,差异有统计学意义(P<0. 05); FGF23与i PTH、P呈正相关(r=0. 463、0. 502,P<0. 05),而与1,25(OH)_2D_3、估计肾小球滤过率(e GFR)呈负相关(r=-0. 503和-0. 489,P<0. 05),与Ca、股骨颈BMD、腰椎BMD无相关性(P>0. 05)。结论尿毒症患者FGF23水平明显升高,其与活性维生素D,血磷、i PTH,肾功能有一定关系,值得进一步研究。
Objective To investigate the level and clinical significance of serum fiber growth factor 23( FGF23) in uremic patients.Methods 82 cases of uremia patients( uremia group) treated in our hospital from January 2016 to February 2018 were selected,and 90 healthy volunteers were selected as the control group. Serum FGF23,parathyroid hormone( i PTH),calcium( Ca),phosphorus( P) and other indicators were detected in the two groups.Bone density( BMD) of lumbar vertebra and femoral neck was measured at the same time.Results The serum levels of FGF23,i PTH and P in the uremia group were( 270. 03± 87. 48) ng/L,( 42. 39±13. 20) pmol/L and( 2. 14±0. 24) mmol/L respectively,higher than those in the control group,and the difference was statistically significant( P < 0. 05). Ca and 1,25-hydroxyvitamin D3[1,25(OH)_2D_3]were( 1. 80± 0. 22) mmol/L and 9. 89( 1. 32,54. 39) ng/L respectively,lower than the control group,and the difference was statistically significant( P<0. 05).The BMD levels of the femoral neck and lumbar spine in the uremia group were( 0. 71± 0. 12) g/m2 and( 0. 67± 0. 14) g/m~2 respectively,lower than those in the control group,and the difference was statistically significant( P<0. 05).FGF23 was positively correlated with i PTH and P( r = 0. 463,0. 502,P < 0. 05),negatively correlated with 1,25( OH)_2D_3 and estimated glomerular filtration rate( e GFR)( r =-0. 503,-0. 489,P<0. 05),but not significantly correlated with Ca,femoral neck BMD and lumbar BMD( P > 0. 05).Conclusion The level of FGF23 in uremic patients was significantly increased,which was related to active vitamin D,blood phosphorus,i PTH,and renal function,and was worthy of further study.
Objective To investigate the level and clinical significance of serum fiber growth factor 23( FGF23) in uremic patients.Methods 82 cases of uremia patients( uremia group) treated in our hospital from January 2016 to February 2018 were selected,and 90 healthy volunteers were selected as the control group. Serum FGF23,parathyroid hormone( i PTH),calcium( Ca),phosphorus( P) and other indicators were detected in the two groups.Bone density( BMD) of lumbar vertebra and femoral neck was measured at the same time.Results The serum levels of FGF23,i PTH and P in the uremia group were( 270. 03± 87. 48) ng/L,( 42. 39±13. 20) pmol/L and( 2. 14±0. 24) mmol/L respectively,higher than those in the control group,and the difference was statistically significant( P < 0. 05). Ca and 1,25-hydroxyvitamin D3[1,25(OH)_2D_3]were( 1. 80± 0. 22) mmol/L and 9. 89( 1. 32,54. 39) ng/L respectively,lower than the control group,and the difference was statistically significant( P<0. 05).The BMD levels of the femoral neck and lumbar spine in the uremia group were( 0. 71± 0. 12) g/m2 and( 0. 67± 0. 14) g/m~2 respectively,lower than those in the control group,and the difference was statistically significant( P<0. 05).FGF23 was positively correlated with i PTH and P( r = 0. 463,0. 502,P < 0. 05),negatively correlated with 1,25( OH)_2D_3 and estimated glomerular filtration rate( e GFR)( r =-0. 503,-0. 489,P<0. 05),but not significantly correlated with Ca,femoral neck BMD and lumbar BMD( P > 0. 05).Conclusion The level of FGF23 in uremic patients was significantly increased,which was related to active vitamin D,blood phosphorus,i PTH,and renal function,and was worthy of further study.
引文
[1]邓晓风,代青,万莉,等.多模式组合透析对维持性血液透析患者Klotho蛋白、FGF-23和BNP的影响[J].中华危重病急救医学,2017,29(7):636-639.
[2]郑斌,万秀贤,毕晓斐,等.不同透析方式下尿毒症患者贫血指标比较[J].广东医学,2017,38(23):3644-3645.
[3]刘力,王志权,马志强,等.冠脉支架置入术后支架内狭窄尿毒症患者的外周血血栓弹力图观察[J].山东医药,2017,57(23):92-93.
[4]张焱,高峰.血液透析滤过与血液透析联合血液灌流治疗尿毒症顽固性高血压的疗效比较[J].中国中西医结合急救杂志,2016,23(2):203-204.
[5]吴明,杨秀林,周永刚,等.无创呼吸机治疗对尿毒症并急性左心衰患者的临床疗效分析[J].第三军医大学学报,2016,38(21):2353-2356.
[6]Imazu M,Takahama H,Kitakaze M.Reply to‘Use of serum fibroblast growth factor 23 vs.plasma B-type natriuretic peptide levels in assessing the pathophysiology of patients with heart failure’.[J].Hypertension Research,2017,40(2):181-188.
[7]马欣,王丽,芶芳芳,等.伊马替尼对尿毒症心肌病大鼠心肌纤维化的保护作用[J].重庆医学,2016,19(3):313-316.
[8]Sato H,James KJ,Murasawa A,et al.Serum Fibroblast Growth Factor23(FGF23)in Patients with Rheumatoid Arthritis[J].Internal Medicine,2016,55(2):121.
[9]郑淑蓓,郑育,李占园,等.成纤维细胞生长因子23、Klotho蛋白与血液透析患者骨密度改变的关系[J].中华肾脏病杂志,2016,32(5):321-326.
[10]Mukhin NA,Milovanov YS,Kozlovskaya LV,et al.The serum level of the morphogenetic protein fibroblast growth factor 23(FGF-23)as a marker for the efficiency of hyperphosphatemia therapy with phosphate-binding agents in chronic kidney disease[J].Terapevticheskii Arkhiv,2016,88(4):41.
[11]陈金艳,胡勇,孙红,等.慢性肾脏病患者成纤维细胞生长因子23、Klotho蛋白与颈动脉内膜中膜厚度的相关性[J].中国动脉硬化杂志,2017,25(9):919-922.
[12]仲思,范秋灵,彭凌燕,等.成纤维细胞生长因子23与持续性非卧床腹膜透析患者腹主动脉钙化关系研究[J].中国实用内科杂志,2016,11(8):680-683.
[13]赵文静,褚以德,王宁宁,等.血清成纤维细胞生长因子23在维持性血液透析患者血管钙化中作用的研究进展[J].山东医药,2016,56(37):104-106.
[14]He X,Hu X,Ma X,et al.Elevated serum fibroblast growth factor 23levels as an indicator of lower extremity atherosclerotic disease in Chinese patients with type 2 diabetes mellitus[J].Cardiovascular Diabetology,2017,16(1):77.
[15]邢文,赵春梅,王德国.血清成纤维细胞生长因子23与慢性心力衰竭心室重构的相关性[J].临床心血管病杂志,2016,19(1):36-39.
[2]郑斌,万秀贤,毕晓斐,等.不同透析方式下尿毒症患者贫血指标比较[J].广东医学,2017,38(23):3644-3645.
[3]刘力,王志权,马志强,等.冠脉支架置入术后支架内狭窄尿毒症患者的外周血血栓弹力图观察[J].山东医药,2017,57(23):92-93.
[4]张焱,高峰.血液透析滤过与血液透析联合血液灌流治疗尿毒症顽固性高血压的疗效比较[J].中国中西医结合急救杂志,2016,23(2):203-204.
[5]吴明,杨秀林,周永刚,等.无创呼吸机治疗对尿毒症并急性左心衰患者的临床疗效分析[J].第三军医大学学报,2016,38(21):2353-2356.
[6]Imazu M,Takahama H,Kitakaze M.Reply to‘Use of serum fibroblast growth factor 23 vs.plasma B-type natriuretic peptide levels in assessing the pathophysiology of patients with heart failure’.[J].Hypertension Research,2017,40(2):181-188.
[7]马欣,王丽,芶芳芳,等.伊马替尼对尿毒症心肌病大鼠心肌纤维化的保护作用[J].重庆医学,2016,19(3):313-316.
[8]Sato H,James KJ,Murasawa A,et al.Serum Fibroblast Growth Factor23(FGF23)in Patients with Rheumatoid Arthritis[J].Internal Medicine,2016,55(2):121.
[9]郑淑蓓,郑育,李占园,等.成纤维细胞生长因子23、Klotho蛋白与血液透析患者骨密度改变的关系[J].中华肾脏病杂志,2016,32(5):321-326.
[10]Mukhin NA,Milovanov YS,Kozlovskaya LV,et al.The serum level of the morphogenetic protein fibroblast growth factor 23(FGF-23)as a marker for the efficiency of hyperphosphatemia therapy with phosphate-binding agents in chronic kidney disease[J].Terapevticheskii Arkhiv,2016,88(4):41.
[11]陈金艳,胡勇,孙红,等.慢性肾脏病患者成纤维细胞生长因子23、Klotho蛋白与颈动脉内膜中膜厚度的相关性[J].中国动脉硬化杂志,2017,25(9):919-922.
[12]仲思,范秋灵,彭凌燕,等.成纤维细胞生长因子23与持续性非卧床腹膜透析患者腹主动脉钙化关系研究[J].中国实用内科杂志,2016,11(8):680-683.
[13]赵文静,褚以德,王宁宁,等.血清成纤维细胞生长因子23在维持性血液透析患者血管钙化中作用的研究进展[J].山东医药,2016,56(37):104-106.
[14]He X,Hu X,Ma X,et al.Elevated serum fibroblast growth factor 23levels as an indicator of lower extremity atherosclerotic disease in Chinese patients with type 2 diabetes mellitus[J].Cardiovascular Diabetology,2017,16(1):77.
[15]邢文,赵春梅,王德国.血清成纤维细胞生长因子23与慢性心力衰竭心室重构的相关性[J].临床心血管病杂志,2016,19(1):36-39.