中国血液净化

中国血液净化 ›› 2023, Vol. 22 ›› Issue (08): 574-578.doi: 10.3969/j.issn.1671-4091.2023.08.002

• 临床研究 • 上一篇    下一篇

血清HO-1、HIF-1α及FGF23对腹膜透析患者血管钙化的影响

陈惠霞    王玮玮     党 珊    赵占锋   

  1. 454111 焦作，1焦作煤业(集团)有限责任公司中央医院肾脏风湿免疫科 450000 郑州，2郑州市第七人民医院肾移植肾内病区
  • 收稿日期:2023-04-06 修回日期:2023-06-02 出版日期:2023-08-12 发布日期:2023-08-12
  • 通讯作者: 陈惠霞 E-mail:jiebi68109@163.com
  • 基金资助:
    2019年河南省医学科技攻关计划联合共建项目(LHGJ20191106)

Effect of serum HO-1, HIF-1α and FGF23 on vascular calcification in peritoneal dialysis patients

CHEN Hui-xia, WANG Wei-wei, DANG Shan, ZHAO Zhan-feng   

  1. Department of Nephrology, Rheumatology and Immunology, The Central Hospital of Jiaozuo Coal Industry (Group) Co., Ltd., Jiaozuo 454111, China; 2Department of Renal Transplantation, Zhengzhou Seventh People's Hospital, Zhengzhou 450000, China
  • Received:2023-04-06 Revised:2023-06-02 Online:2023-08-12 Published:2023-08-12
  • Contact: 454111 焦作，1焦作煤业(集团)有限责任公司中央医院肾脏风湿免疫科 E-mail:jiebi68109@163.com

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摘要： 目的  探讨血清血红素加氧酶-1(heme oxygenase-1，HO-1)、低氧诱导因子-1α(hypoxia inducible factor-1α，HIF-1α)及成纤维细胞生长因子23(fibroblast growth factor23，FGF23)对腹膜透析患者血管钙化的影响。 方法  选取2019年5月—2022年5月焦作煤业(集团)有限责任公司中央医院收治的109例腹膜透析患者，采用腹部侧位X线平片检测腹膜透析患者血管钙化情况。根据是否发生腹主动脉钙化分为钙化组、无钙化组。比较2组血清HO-1、HIF-1α、FGF23水平、临床资料，采用Logistic回归分析腹膜透析患者腹主动脉钙化的影响因素，采用ROC曲线分析血清HO-1、HIF-1α、FGF23水平对腹主动脉钙化的预测价值。 结果  钙化组血清HO-1水平低于无钙化组(t=5.762，P＜0.001)，HIF-1α、FGF23水平高于无钙化组(t=8.176、9.382，均P＜0.001、＜0.001)；Logistic回归分析显示年龄(OR =1.359，95% CI 1.048～1.763，P＜0.001)、血磷(OR =1.994，95% CI 1.123～3.539，P＜0.001)、HO-1(OR =0.857，95% CI 0.762～0.964，P＜0.001)、HIF-1α(OR =2.211，95% CI 1.156～4.228，P＜0.001)、FGF23(OR=3.916，95% CI 1.957～7.836，P＜0.001)是腹膜透析患者发生腹主动脉钙化的影响因素；HO-1、HIF-1α、FGF23及三者联合预测腹主动脉钙化的AUC分别为0.789、0.868、0.902、0.972。 结论  血清HO-1、HIF-1α、FGF23水平是腹膜透析患者腹主动脉钙化的独立影响因素，三者均对腹主动脉钙化具有一定预测价值，联合预测价值更高。

关键词: 成纤维细胞生长因子23, 血红素加氧酶-1, 低氧诱导因子-1α, 腹膜透析, 血管钙化

Abstract: Objective   To investigate the effects of serum heme oxygenase-1 (HO-1), hypoxia inducible factor-1α (HIF-1α) and fibroblast growth factor 23 (FGF23) on vascular calcification in peritoneal dialysis (PD) patients.  Methods   A total of 109 PD patients admitted to The Central Hospital of Jiaozuo Coal Industry (Group) Co., Ltd. from May 2019 to May 2022 were selected. Lateral abdominal plain radiographs were used to detect vascular calcification in the PD patients. According to the presence or absence of abdominal aortic calcification, patients were divided into the calcification group and the non-calcification group. Clinical data and serum HO-1, HIF-1α and FGF23 were compared between the two groups. Logistic regression was used to analyze the influencing factors of abdominal aortic calcification in PD patients. The predictive values of serum HO-1, HIF-1α and FGF23 for abdominal aortic calcification were analyzed by ROC curve.  Results  Serum HO-1 was lower, and serum HIF-1α and FGF23 levels were higher in calcification group than in non-calcification group (t=5.762, 8.176, and 9.382 respectively; P＜0.001). Logistic regression showed that age (OR=1.359, 95% CI 1.048～1.763, P<0.001), serum phosphorus (OR=1.994, 95% CI 1.123～3.539, P＜0.001), HO-1 (OR=0.857, 95% CI 0.762～0.964, P＜0.001), HIF-1α (OR=2.211, 95% CI 1.156～4.228, P＜0.001) and FGF23 (OR=3.916, 95% CI 1.957～7.836, P＜0.001) were the factors affecting the presence of abdominal aortic calcification in PD patients. The AUC predicted by HO-1, HIF-1α, FGF23 and their combination were 0.789, 0.868, 0.902 and 0.972 respectively.  Conclusions   Serum HO-1, HIF-1α and FGF23 levels are the independent influencing factors for abdominal aortic calcification in PD patients. Anyone of the three levels has a predictive value, but their combined has a higher predictive value for the presence of abdominal aortic calcification.

Key words: Fibroblast growth factor 23; , Heme oxygenase-1; , Hypoxia inducible factor-1α; , Peritoneal dialysis; , Vascular calcification

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