慢性心力衰竭患者肾脏损害与成纤维细胞生长因子23的相关性分析

目的 探讨慢性心力衰竭患者肾脏损害与成纤维细胞生长因子23（FGF23）的相关性.方法 289例慢性心力衰竭患者,根据肾小球滤过率（eGFR）结果将入选的289例患者分为3组：肾功能正常组,肾功能轻度下降组和肾功能中、重度下降组.入院时采血测定患者血清FGF23水平、N末端B型钠尿肽（NT-proBNP）及肾功能指标肌酐、尿素氮和计算eGFR,心脏彩色超声测定左室射血分数（LVEF）和左心室舒张末内径（LVEDD）等.结果 3组患者心肾功能的恶化趋势一致.FGF23水平随着肾功能的恶化明显升高,肾功能中重度下降的患者血清FGF223明显高于肾功能轻度下降和正常组患者（P＜0.05）.在慢性心力衰竭患者中,血清FGF23水平与肾功能指标尿素氮、肌酐和eGFR均呈正相关,相关系数分别为0.532、0.686、0.783,差异具有统计学意义（P＜0.05）.血清FGF23水平与心功能指标NT-proBNP呈正相关（r=0.652,P＜0.05）,与射血分数呈负相关（r=-0.521,P＜0.05）.结论 心力衰竭程度、心力衰竭肾脏损伤程度与血清高水平FGF23有关.

Correlation analysis on fibroblast growth factor 23 and renal impairment in patients with chronic heart failure

Objective To explore the correlation between fibroblast growth factor 23（FGF23） and renal impairment in patients with chronic heart failure （CHF）.Methods 289 patients with CHF were included in the present study.According to the glomerular filtration rate,289 patients were divided into three groups,including the normal renal function group,the mild renal dysfunction group and the moderate and severe renal dysfunction group.On admission,the serum FGF23,N-terminal pro-brain natriuretic peptide （NT-proBNP）,creatinine （Cr） and blood urea nitrogen （BUN） were analyzed.The glomerular filtration rate （eGFR） was calculated.Left ejection fraction （EF） and left ventricular end-diastolic dimension were measured by ultrasonic cardiogram.Results The same trend of cardiac and renal function deterioration was observed in patients of the three groups.With the deterioration of renal function,the serum FGF23 was increased.Compared with the normal renal function group and the mild renal dysfunction group,FGF23 was significantly increased in patients of severe renal dysfunction group.The serum FGF23 was positively correlated with Cr,BUN and eGFR,and the correlation coefficents were 0.532,0.686 and 0.783 respectively,P 〈 0.05.The serum FGF23 was positively correlated with NT-proBNP （r=0.652,P 〈 0.05） and negatively correlated with EF （r=-0.521,P 〈 0.05）.Conclusion The degree of heart failure and heart failure with renal impairment were associated with the high level of serum FGF23.