血清FGF-23水平与慢性肾脏病患者心律失常的关系

目的探讨血清成纤维细胞因子23(FGF-23)水平与慢性肾脏病患者心律失常之间的关系。方法纳入2016年3月—2018年10月在新疆医科大学第五附属医院肾内科住院的非透析2~5期慢性肾脏病患者140例,按照24 h动态心电图诊断有无心律失常分为心律失常组和非心律失常组,对比2组之间的人口学特征、FGF-23水平及其他相关生化指标水平。再根据心律失常类型将心律失常组患者分为房性心律失常组、室性心律失常组和房性合并室性心律失常组,对比各组之间年龄、体质量指数、FGF-23水平及其他生化指标水平。利用二元Logistic回归分析明确慢性肾脏病患者血清FGF-23水平与心律失常间的关系。结果心律失常组患者年龄、冠心病患病率、血清FGF-23及血钙水平均显著高于非心律失常组(P均<0.05),高密度脂蛋白胆固醇水平(HDL-C)显著低于非心律失常组(P<0.05);室性心律失常组和房性合并室性心律失常组患者血清FGF-23水平均明显高于房性心律失常组患者(P均<0.05)。Logistic回归分析表明经调整混杂因素后,FGF-23水平是慢性肾脏病患者心律失常的独立危险因素。结论血清FGF-23水平是慢性肾脏病患者心律失常的独立危险因素,调控FGF-23水平可能会成为治疗慢性肾脏病患者心律失常的新靶点。

Association between serum FGF-23 level and arrhythmia in the patients with chronic kidney disease

Objective It is to explore the relationship between serum fibroblast factor 23(FGF-23)level and arrhythmia in patients with chronic kidney disease.Methods 140 patients with chronic kidney disease of non-dialysis stage 2 to 5 who were hospitalized in the Department of Nephrology of the Fifth Affiliated Hospital of Xinjiang Medical University from March 2016 to October 2018 were enrolled and divided into arrhythmia group and non-arrhythmic group according to arrhythmia diagnosed by 24h dynamic electrocardiogram,the demographic characteristics,FGF-23 level and other related biochemical indicators were compared between the two groups.According to the type of arrhythmia,the patients in arrhythmia group were divided into atrial arrhythmia group,ventricular arrhythmia group and atrial combined ventricular arrhythmia group(combination group),the demographic characteristics,FGF-23 level and other related biochemical indicators were compared among the three groups.Binary Logistic regression analysis was used to clarify the relationship between serum FGF-23 level and arrhythmia in patients with chronic kidney disease.Results The age,prevalence of coronary heart disease,serum FGF-23 and blood calcium levels in the arrhythmia group were significantly higher than those in the non-arrhythmia group(all P<0.05),and the high-density lipoprotein cholesterol level(HDL-C)was significantly lower that that in the non-arrhythmic group(P<0.05);the serum FGF-23 level of patients in ventricular arrhythmia group and the combination group was significantly higher than that in patients in atrial arrhythmia group(P<0.05).Logistic regression analysis showed that after adjusting for confounding factors,FGF-23 level was an independent risk factor for arrhythmia in patients with chronic kidney disease.Conclusion:Serum FGF-23 level is an independent risk factor for arrhythmia in patients with chronic kidney disease,and regulating FGF-23 level may become a new target for the treatment of arrhythmia in patients with chronic kidney disease.