中国血液净化

中国血液净化 ›› 2015, Vol. 14 ›› Issue (04): 199-202.doi: 10.3969/j.issn.1671-4091.2015.04.003

• 临床研究 • 上一篇    下一篇

维持性血液透析患者血清FGF23和Klotho水平及其与左心室肥厚关系的研究

王英,贾艳丽,王银娜,孙懿   

  1.  首都医科大学附属复兴医院肾内科
  • 收稿日期:2014-07-25 修回日期:2015-02-06 出版日期:2015-04-12 发布日期:2015-04-20
  • 通讯作者: 王英 wyyu17@163.com E-mail:wy_daisy@126.com

The levels of serum FGF23 and Klotho in maintenance hemodialysis patients and the relationship with left ventricular hypertrophy

  • Received:2014-07-25 Revised:2015-02-06 Online:2015-04-12 Published:2015-04-20

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摘要： 目的检测维持性血液透析(maintenance hemodialysis,MHD)患者血清成纤维细胞生长因子23(fibroblast growth factor 23,FGF23)和Klotho 蛋白水平，探讨它们与左心室肥厚之间的关系。方法选取首都医科大学附属复兴医院病情稳定的MHD 患者46 例。采用酶联免疫吸附技术测定血清FGF23 和Klotho 蛋白水平。其他指标有血清全段甲状旁腺激素(iPTH)、血钙、血磷、白蛋白、B 型脑钠肽、血红蛋白、肾功能等，并进行超声心动检测，根据Devereux 公式计算左室质量指数(LVMI)。结果① MHD 患者血清FGF23 水平为(1829.29±1947.05)ng/L，明显高于正常人水平(10.48±8.93 )ng/L，差异有统计学意义(P＜0.01)。,MHD 患者血清Klotho 水平为(283.26±219.06)ng/L，明显低于同年龄正常人血清Klotho 水平(1125.50±126.96)ng/L，差异有统计学意义(P＜0.01)。②Pearson 相关分析显示，MHD 患者Log Klotho 与Log FGF23 呈负相关(r=-0.929，P＜0.01)。Log Klotho 和Log FGF23 与超声心动图检测的各项指标无相关关系。③ MHD 患者左心室肥厚的发生率为61%，LVMI 与收缩压、B 型脑钠肽呈正相关(P＜0.01)。多元逐步回归分析显示，B 型脑钠肽是影响左心室肥厚的独立危险因素。结论① MHD 患者血清FGF23 水平明显升高，血清Klotho 水平明显降低。②MHD 患者左心室肥厚的发生率高，B 型脑钠肽是影响左心室肥厚的独立危险因素，未发现血清FGF23 和Klotho 水平与左心室肥厚有相关关系。

关键词: 血液透析, Klotho, 成纤维细胞生长因子23, 左心室肥厚, B型脑钠肽

Abstract: Objective To detect the levels of serum fibroblast growth factor 23 (FGF-23) and Klotho in MHD patients and find the relationship to left ventricular hypertrophy(LVH). Methods 46 MHD patients and 10 healthy persons(control group) were enrolled in the study. Serum FGF-23 and Klotho were measured using enzyme-linked immunosorbent assay. Other circulating parameters include: intact parathyroid hormone, calcium, phosphate, albumin, brain natriuretic peptide, hemoglobin, renal function, and so on. LVH patients were found using echocardiography. Results The level of serum FGF23 was significantly higher than that in healthy persons[(1829.29±1947.05)ng/L vs. (10.48±8.93 )ng/L](P<0.01)。The level of serum Klotho was significantly lower than that in healthy persons [（283.26±219.06）ng/L vs. (1125.50±126.96 )ng/L] (P<0.01)。Log Klotho was negatively associated with Log FGF23（r=-0.929，P<0.01）. Sixty-one percent of MHD patients had LVH. LVMI was positively associated systolic blood pressure, brain natriuretic peptide and the average ultrafiltration volume.In the multivariable linear regression model, brain natriuretic peptide and the average ultrafiltration volume were independent risk factors for LVH. Conclusions The level of serum FGF23 increases, while Klotho decreases significantly in MHD patients. The prevalence of LVH in MHD patients is high. Brain natriuretic peptide and the average ultrafiltration volume were the independent risk factors for lVH. We did not find any relationship between FGF23 and LVH, or klotho and LVH.

Key words: hemodialysis, Klotho, FGF23, left ventricular hypertrophy, brain natriuretic peptide