中国血液净化

中国血液净化 ›› 2021, Vol. 20 ›› Issue (06): 410-414.doi: 10.3969/j.issn.1671-4091.2021.06.013

• 血管通路 • 上一篇    下一篇

血清成纤维细胞生长因子23 在桡动脉钙化及动静脉内瘘失功中的预测作用

张志坚1,陈涵枝1,刘斌1,刘晓斌1,陈勇1,常艳华1,单炜薇1,王凉1,孙铸兴1   

  1. 1南京医科大学附属无锡市人民医院肾内科

  • 收稿日期:2020-11-09 修回日期:2021-03-15 出版日期:2021-06-12 发布日期:2021-06-17
  • 通讯作者: 孙铸兴 wuxisunzx@126.com E-mail:zhangzhijianwx@163.com
  • 基金资助:
    南京医科大学科技发展基金重点项目(2017NJMUZD124)

Serum fibroblast growth factor-23 (FGF-23) level for predicting radial artery calcification and arteriovenous fistula dysfunction in hemodialysis patients

  1. 1Department of Nephrology, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi 214023, China
  • Received:2020-11-09 Revised:2021-03-15 Online:2021-06-12 Published:2021-06-17

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摘要： 【摘要】目的探讨成纤维细胞生长因子23(fibroblast growth factor-23，FGF-23)水平在终末期肾病(end stage renal disease，ESRD)患者桡动脉钙化(radial artery calcification，RAC)与自体动静脉内瘘(arteriovenous fistula，AVF)失功中的预测价值。方法收集212 例在南京医科大学附属无锡市人民医院行AVF 手术的ESRD 患者的临床资料，采用ELISA 检测患者术前血清FGF-23 水平。采用HE染色法对桡动脉血管进行钙化染色以评估RAC 程度。据随访期间临床及影像学资料将患者分为AVF 失功及AVF 通畅组。比较FGF-23 水平在不同分组中的差异及预测作用。结果212 例患者中有57.8%发生RAC(123/212)。当cut- off 值取FGF- 23＞488.5ng/ml 时，FGF- 23 预测RAC 的敏感性为0.797，特异性为0.921；当cut-off 值取FGF-23＞490.9ng/ml 时，预测AVF 失功的敏感性为0.757，特异性为0.560。结论ESRD 患者RAC的发生率高，FGF-23 可能是预测RAC 及AVF 失功的理想标志物。

关键词: 血液透析, 桡动脉钙化, 动静脉内瘘, 成纤维细胞生长因子23

Abstract: 【Abstract】Objective To investigate the relationship between serum fibroblast growth factor-23 (FGF-23) level and radial artery calcification (RAC) and arteriovenous fistula (AVF) dysfunction in hemodialysis patients. Methods This prospective study included 212 maintenance hemodialysis (MHD) patients undergoing AVF surgery. Serum FGF-23 level was measured by ELISA. Clinical and biochemical data were collected. RAC was assayed by hematoxylin- eosin staining. Serum FGF- 23 levels were compared between patient groups, and the prediction effect of serum FGF- 23 level was then evaluated. Results The prevalence of RAC was 57.8% (123/212) in the MHD patients. When the cut-off value of serum FGF-23 level was set at 488.5 ng/ml, the sensitivity and specificity for the diagnosis of RAC were 0.797 and 0.921 respectively. When the cut-off value of serum FGF-23 level was set at 490.9 ng/ml, the sensitivity and specificity for the diagnosis of AVF dysfunction were 0.757 and 0.560 respectively. Conclusion Higher prevalence of RAC was found in end-stage renal disease patients. Serum FGF-23 appears to be a sensitive and specific marker of RAC and AVF dysfunction in hemodialysis patients.

Key words: Hemodialysis, Radial artery calcification, Arteriovenous fistula, Fibroblast growth factor-23

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