成纤维细胞生长因子23与维持性血液透析患者左心室肥厚的关系

目的 观察维持性血液透析（MHD）患者成纤维细胞生长因子23（FGF23）与左心室肥厚（LVH）的关系.方法 测定64例MHD患者收缩压、舒张压、血红蛋白（Hb）、血清FGF23、全段甲状旁腺素（iPTH）、血清肌酐（Scr）、钙、磷、C反应蛋白（CRP）等指标,同时行心脏彩超观察室间隔厚度（IVST）、左室后壁厚度（PWT）、左室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）等指标,计算左心室质量指数（LVMI）.结果 MHD患者LVH的发生率为60%.LVH患者血磷、FGF23、CRP水平明显高于无LVH的患者（P＜0.05）,收缩压水平亦明显高于无LVH患者（P＜0.01）;而血红蛋白水平则明显低于无LVH患者（P＜0.05）.LVMI与血磷、FGF23、CRP水平正相关,与血红蛋白水平负相关.结论 MHD患者LVH发生率高,LVH患者血磷、FGF23、CRP水平明显升高.FGF23和高血磷可能参与MHD患者LVH的发生.

The relation between serum level of fibroblat growth factor 23 and left ventricular hypertrophy in maintenance hemodialysis patients

Objective ： To investigate the relation between serum level of fibroblat growth factor 23 and left ventricular hypertrophy in MHD patients. Methods Conventional hemodialysis was performed in sixty-four patients thrice every week. Serum level of FGF23 was detected by enzyme-linked immunosorbent assay（ELISA） in MHD patients and thirty CKD patients （control group）. Serum hemoglobulin, intact PTH, creatinine, calcium, albumin and phosphate were also measured at the same time. Cardiac structural parameterswere assessed by Doppler echocardiography, which includes left ventricular end-diastolic diameter（ LVEDD）, left ventricular end-systolic diameter （ LVESD ）, posterior wall thickness （ PWT ）, interventricular septum thickness（IVST）. Results Left ventricular hypertrophy occurred in 60% of the MHD patients. Patients with left ventricular hypertrophy had higher levels of serum phosphate, FGF23, CRP, and systolic blood pressure,while had lower levels of serum hemoglobulin. Conclusion Left ventricular hypertrophy has a high prevalence in MHD patients, and is associated with higher levels of FGF23 and phosphate. FGF23 may paly an important role in the pathogenesis of left ventricular hypertrophy.