维持性血液透析患者成纤维细胞生长因子23与心血管病变的临床研究

目的分析维持性血液透析（MHD）患者血清成纤维细胞生长因子23（FGF-23）与心血管病变的关系,探讨FGF-23对心血管疾病的影响机制。方法选取本院MHD患者50例,应用夹心酶联免疫吸附法（ELISA法）检测FGF-23,同时行血液生化指标、彩色多普勒超声心动图、颈部血管超声检查。结果 MHD患者血清FGF-23水平较健康对照组显著升高（P〈0.01）。相关性分析显示,MHD患者血清FGF-23与血清肌酐、磷、全段甲状旁腺激（iPTH）呈正相关（P〈0.01）,与1,25-二羟维生素D3[1,25-（OH）2VitD]呈负相关（P〈0.01）,与血清钙无关（P〉0.05）。心血管病变组血清FGF-23显著高于非心血管病变组（P〈0.01）。逐步多元回归分析显示FGF-23是颈总动脉内-中膜厚度（β=0.189,P〈0.01）的独立危险因素。结论 MHD患者FGF-23水平明显升高,提示其是重要的磷调节因子。FGF23与MHD患者心血管病变的发生发展密切相关。

Clinical Research on Relationship between Serum Fibroblast Growth Factor 23 and Cardiovascular Disease in Maintenance Hemodialysis Patients

Objective To investigate the relationship between serum fibroblast growth factor 23 and cardiovascular disease in maintenance hemodialysis patients.Methods A prospective cohort study was conducted in 50 maintenance hemodialysis patients.Their serum 1,25（OH）2VitD,and FGF-23 were measured by ELISA,together with echocardiography and dialysis indices.Results Concentrations of FGF-23 increased in all of the patients.Serum FGF-23 level was higher in MHD patients with cardiovascular diseases than that in those without（P0.01）.By relativity analysis,Serum FGF-23 level was positively correlated with serum creatinine,phosphorus and iPTH（P0.01）,and it was negatively correlated with 1,25-（OH）2VitD（P0.01） and not correlated with serum calcium（P0.05）.Multiple regression analysis showed that serum FGF-23 1evel was the independent risk factor of intima-media thickness of common carotid artery in MHD patients.Conclusion High level of serum FGF-23 has close correlation with onset of cardiovascular disease in patients with maintenance hemodialysis.