中国血液净化

中国血液净化 ›› 2013, Vol. 12 ›› Issue (10): 557-560.doi: 10.3969/j.issn.1671-4091.2013.10.00

• 临床研究 • 上一篇    下一篇

血液透析患者成纤维细胞生长因子23水平及相关性分析

  

  1. 030001 太原，1山西医科大学第一医院肾内科 100048 北京，2解放军总医院第一附属医院肾内科 100029 北京，3中日友好医院肾内科
  • 收稿日期:2013-08-07 修回日期:2013-08-26 出版日期:2013-10-12 发布日期:2013-10-12
  • 通讯作者: 郭瑜玲 guoyuling5705@126.com 张凌 Zhangling5@medmail.com.cn E-mail:zhangling5@medmail.com.cn
  • 基金资助:

    北京市首都医学发展科研基金研究资助项目(2009-3023)

Correlation between fibroblast growth factor 23 level and intact parathyroid hormone in maintenance hemodialysis patients

  • Received:2013-08-07 Revised:2013-08-26 Online:2013-10-12 Published:2013-10-12

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摘要： 【摘要】 目的 观察维持性血液透析（maintenance hemodialysis,MHD）患者成纤维细胞生长因子23（fibroblast growth factor 23,FGF-23）的水平，分析其与全段甲状旁腺激素(intact parathyroid hormone,iPTH)等生化指标的关系，探讨FGF-23对MHD患者的临床意义。方法 选取行MHD治疗的患者41例，健康志愿者12例为对照组，收集一般情况及化验指标，采集血清检测FGF-23，并进行相关性分析。结果（1）MHD各组与对照组年龄、性别无显著差异，但MHD患者FGF-23显著高于对照组[1077.4±967.46pg/ml 比73.99±19.58pg/ml，P<0.001]；（2）依据iPTH不同将MHD分为A组(低iPTH组)、B组(iPTH达标组)、C组(高iPTH组)；FGF-23在三组间有显著性差异，分别为477.44±2293.53pg/ml、176.57±402.39pg/ml、1433.1±1984.76pg/ml ，P=0.016；（3）将MHD患者依据血磷不同水平分组比较，观察到高血磷组与非高血磷组相比，iPTH显著升高1319.66±1015.96pg/ml 比583.36±980.81pg/ml（P=0.012）、FGF-23也显著升高1506.83± 957.97pg/ml 比 452.31±696.12pg/ml（P<0.001）；（4）相关性分析显示：血钙（r=0.381，P=0.005）、磷（r=0.593，P<0.001）、钙磷乘积（r=0.656，P<0.001）、ALP（r=0.276，P=0.045）均与FGF-23呈正相关。而iPTH在B组及C组与FGF-23呈正相关（r=0.384，P=0.005），在A组与FGF-23无相关性。结论 MHD患者中FGF-23与血清钙、磷、钙磷乘积、ALP、iPTH密切相关，在继发性甲状旁腺功能亢进症（secondary hyperparathyroidism,SHPT）的发生中起着重要作用。

关键词: 血液透析, 成纤维细胞生长因子23, 甲状旁腺激素

Abstract: Objective We investigated the significance of fibroblast growth factor 23 (FGF23) in maintenance hemodialysis (MHD) patients by measuring serum FGF23 and correlating FGF23 with intact parathyroid hormone levels (iPTH) and other biochemical markers in these patients. Methods Forty-one MHD patients were enrolled in this study, and 12 healthy individuals were used as the control group. Demographic information, serum FGF23 and other laboratory indexes were collected and analyzed. Results ① Serum FGF23 was significantly higher in MHD group than in control group (P＜0.01). ② When MHD patents were sub-grouped into group A (with lower iPTH level), group B (with normal iPTH level), and group C (with higher iPTH level). Serum FGF23 in the group A, B and C was 477.44±2293.53pg/ml, 176.57±402.39pg/ml and 1433.1±1984.76pg/ml, respectively, significantly different among the 3 groups (P=0.016). ③ When MHD patients were sub-grouped into hyperphosphatemia group and normal serum phosphate group. Compared to the normal serum phosphorus group, iPTH and FGF23 in the hyperphosphatemia group increased significantly (1319.66±1015.96pg/ml vs. 583.36±980.81pg/ml for iPTH, P<0.05; 1506.83±957.97pg/ml vs. 452.31±696.12pg/ml for FGF23, P＜0.001). ④ Serum FGF23 was positively correlated with serum calcium, phosphorus, ALP and calcium-phosphorus product (r=0.381, P<0.01 for calcium; r=0.593, P<0.001 for phosphorus; r=0.276, P<0.05 for ALP; r=0.656, P<0.001 for calcium-phosphorus product). iPTH was positively correlated with FGF23 in groups B and C (r=0.384, P<0.01), but not in group A. Conclusions In MHD patients, FGF23 was closely related to serum calcium, phosphorus, calcium-phosphorus product, ALP and iPTH. Therefore, FGF23 plays an important role in the presence of secondary hyperparathyroidism.

Key words: Hemodialysis, Fibroblast growth factor 23, Parathyroid hormone