中国血液净化

中国血液净化 ›› 2024, Vol. 23 ›› Issue (02): 97-101.doi: 10.3969/j.issn.1671-4091.2024.02.004

• 临床研究 • 上一篇    下一篇

血清FGF-2、FGF-23与脓毒症合并急性肾损伤CRRT治疗患者肾功能及预后的关系

王贵霞   李振翮     甄国栋    刘加强   

  1. 276400 临沂，临沂市中心医院1血液透析室 2急诊科
  • 收稿日期:2023-09-18 修回日期:2023-12-01 出版日期:2024-02-12 发布日期:2024-02-12
  • 通讯作者: 李振翮 E-mail:13256578007@163.com
  • 基金资助:
    山东省医药卫生科技发展计划项目(202014051327)

Relationship between serum FGF-2 and FGF-23 levels and renal function and its prognosis in sepsis patients with acute kidney injury and treated by continuous renal replacement therapy

LIN Ru, MA Ya-nan, ZHANG Jin-jin, WANG Rui-feng, LIU Gui-ling   

  1. Hemodialysis Section, Linyi Central Hospital, Linyi 276400, China; 2Department of Emergency, Linyi Central Hospital, Linyi 276400, China
  • Received:2023-09-18 Revised:2023-12-01 Online:2024-02-12 Published:2024-02-12
  • Contact: 276400 临沂，临沂市中心医院2急诊科 E-mail:13256578007@163.com

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摘要： 目的  分析血清成纤维细胞生长因子(fibroblast growth factor，FGF)-2、FGF-23与接受连续性肾脏替代治疗(continuous renal replacement therapy，CRRT)的脓毒症合并急性肾损伤(acute kidney injury，AKI)患者肾功能和短期预后的关系。 方法  选取157例接受CRRT治疗的脓毒症合并AKI患者，比较不同AKI分期患者血清FGF-2、FGF-23水平。根据28天预后情况将其分为生存组和死亡组，比较2组血清FGF-2、FGF-23及肾功能指标水平，并分析其相关性。分析血清FGF-2、FGF-23水平对短期预后的预测价值。 结果 AKI Ⅲ期患者血清FGF-2水平低于AKI Ⅱ期，血清FGF-23水平高于AKI Ⅱ期(t=20.149、-8.060，均P＜0.001)。死亡组血清FGF-23、肌酐(Scr)、胱抑素C(Cyc-C)水平高于生存组(t= -12.051、-17.462、-5.881，均P＜0.001)，血清FGF-2、估算肾小球滤过率(estimated glomerular filtration rate，eGFR)低于生存组(t=25.990、15.997，均P＜0.001)。Pearson分析显示血清FGF-2与Scr、Cyc-C均呈负相关(r=-0.511、-0.449,P＜0.001、0.002)，与eGFR呈正相关(r=0.606，P＜0.001)。血清FGF-23与Scr、Cyc-C均呈正相关，与eGFR呈负相关(r=0.610、0.522、-0.654，均P＜0.001)。FGF-2、FGF-23联合应用的预测价值高于两指标单独应用(Z=2.120、2.034，P=0.034、0.042)。 结论  脓毒症合并AKI患者的血清FGF-2水平明显降低、FGF-23水平明显升高，且与患者肾功能下降及短期预后不良有关，二者联合检测对预测脓毒症合并AKI短期预后的价值较高。

关键词: 脓毒症, 急性肾损伤, 连续性肾脏替代治疗, 成纤维细胞生长因子-2, 成纤维细胞生长因子-23, 肾功能, 预后

Abstract: Objective  To analyze the relationship between serum fibroblast growth factor (FGF)-2 and FGF-23 levels and renal function and its short-term prognosis in sepsis patients with acute kidney injury (AKI) and treated by continuous renal replacement therapy (CRRT).  Methods  A total of 157 sepsis patients complicated with AKI and treated by CRRT were enrolled in this study. Serum FGF-2 and FGF-23 levels were compared among patients with different AKI stage. Patients were divided into survival group and death group according to the prognosis at day 28. Serum FGF-2 and FGF-23 levels and renal function indexes were compared between the two groups, and the correlations were analyzed. The predictive value of serum FGF-2 and FGF-23 levels for short-term prognosis of AKI was evaluated.  Results  In patients with AKI Ⅲ, serum FGF-2 level was lower and serum FGF-23 level was higher, as compared those with AKI Ⅱ (t=20.149 and -8.060, P＜0.001). Serum FGF-23, creatinine (Scr) and cystatin C levels were higher in the death group than in the survival group, while serum FGF-2 and eGFR were lower in the death group than in the survival group  (t=-12.051, -17.462, -5.881, 25.990 and 15.997 respectively; P＜0.001). Pearson correlation analysis showed that serum FGF-2 was negatively correlated with Scr and cystatin C, and positively correlated with eGFR   (r=-0.511, -0.449 and 0.606 respectively; P＜0.001, 0.002 and ＜0.001 respectively). Serum FGF-23 was positively correlated with Scr and cystatin C, and negatively correlated with eGFR (r=0.610, 0.522, -0.654 respectively; P＜0.001). The predictive value of combined application of serum FGF-2 and FGF-23 levels was higher than that of the two indicators applied individually (Z=2.120 and 2.034, P=0.034 and 0.042).   Conclusion  Serum FGF-2 level is significantly reduced and FGF-23 level is significantly increased in sepsis patients with AKI. The lower serum FGF-2 level and higher serum FGF-23 level are associated with the decreased renal function and poor short-term prognosis. Simultaneous use of serum FGF-2 and FGF-23 levels improves the prediction value for short-term prognosis in sepsis patients with AKI.

Key words: Sepsis, Acute kidney injury, Continuous renal replacement therapy, FGF-2, FGF-23, Renal function, Prognosis

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