维持性血液透析患者血清FGF-23及klotho水平与血管钙化关系的研究

发布时间：2018-04-30 22:04

本文选题：维持性血液透析 + FGF-23　；参考：《青岛大学》2017年硕士论文

【摘要】：目的:探究维持性血液透析患者血管钙化的发生发展与血清中成纤维细胞生长因子-23(FGF-23)及内分泌型FGF辅助因子(klotho)水平之间的关系,为维持性血液透析患者血管钙化的评估提供一定的理论依据。方法:本研究以126例维持性血液透析患者作为研究对象,详细记录患者的一般临床资料,采用胸部X线摄片,心脏、大动脉的超声检查对患者的血管钙化程度进行准确判断,并根据患者血管钙化程度分组,分为无钙化、轻度钙化和重度钙化组。应用ELISA法对患者的血清FGF-23水平以及klotho水平进行检测,使用Spearman相关分析探讨患者血管钙化的发生与血清FGF-23水平以及klotho水平之间的关系,采用多分类Logistic回归分析来探讨维持性血液透析患者的血管钙化发生和发展的危险因素。结果:本研究中受试者无钙化组31例、轻度钙化组56例、重度钙化组39例,研究显示:1.不同程度血管钙化患者之间的年龄、血清白蛋白水平、血磷、i PTH等均具有显著性差异(均P0.05);2.不同程度血管钙化患者之间的血清FGF-23水平以及klotho水平差异显著(均P0.05)。3.根据患者血管钙化的Spearman相关分析得出结论:患者的血管钙化程度与血清FGF-23水平呈正相关关系(r=0.550,P=0.000),而与klotho水平呈负相关关系(r=-0.386,P=0.000)。4.维持性血液透析患者的血清高FGF-23水平是独立的血管钙化危险因素(OR值为1.031,95%CI为1.010~1.052),而高klotho水平则是保护因素(OR值为0.991,95%CI为0.984~0.998)。结论:对于维持性血液透析患者,血管钙化的程度与血清FGF-23及klotho水平之间具有明显相关性,且患者的血清FGF-23以及klotho水平是影响其血管钙化程度的重要因素。
[Abstract]:Objective: to investigate the relationship between the occurrence and development of vascular calcification in maintenance hemodialysis patients and the levels of serum fibroblast growth factor-23FGF-23 and endocrine FGF cofactor klotho. To provide a theoretical basis for the evaluation of vascular calcification in maintenance hemodialysis patients. Methods: 126 patients with maintenance hemodialysis were studied in this study. The general clinical data of the patients were recorded in detail, and the degree of vascular calcification was accurately judged by chest radiography, echocardiography of the heart and great arteries. According to the degree of vascular calcification, the patients were divided into three groups: non calcified group, mild calcified group and severe calcified group. The serum FGF-23 and klotho levels were detected by ELISA method. The relationship between the occurrence of vascular calcification and the serum FGF-23 and klotho levels was investigated by Spearman correlation analysis. Multiclass Logistic regression analysis was used to investigate the risk factors of vascular calcification in maintenance hemodialysis patients. Results: in this study, there were 31 cases in non-calcification group, 56 cases in mild calcification group and 39 cases in severe calcification group. There were significant differences in age, serum albumin level and serum phosphorous I PTH between patients with different degrees of vascular calcification (all P 0.05). There were significant differences in serum FGF-23 and klotho levels among patients with different degrees of vascular calcification (all P 0.05. 3). According to the Spearman correlation analysis of vascular calcification in patients, it was concluded that the degree of vascular calcification was positively correlated with serum FGF-23 level, but negatively correlated with klotho level. The serum high FGF-23 level was an independent risk factor for vascular calcification in maintenance hemodialysis patients. The OR value was 1.031 卤95 CI 1.010 卤1.052 渭 m, while the high klotho level was a protective factor. The OR value of high klotho level was 0.991-95 CI 0.984 卤0.998g. Conclusion: there is a significant correlation between the degree of vascular calcification and the levels of serum FGF-23 and klotho in patients with maintenance hemodialysis, and the levels of serum FGF-23 and klotho are important factors affecting the degree of vascular calcification.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692.5

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