腹膜透析患者腹主动脉钙化与成纤维细胞生长因子23和可溶性Klotho的相关性

发布时间：2018-07-03 18:33

  本文选题：腹膜透析 + 腹主动脉钙化　； 参考：《肾脏病与透析肾移植杂志》2017年04期

【摘要】：目的:探讨持续非卧床腹膜透析(CAPD)患者腹主动脉钙化与血清成纤维细胞生长因子23(FGF-23)和可溶性Klotho(s KL)水平之间的关系。方法:收集147例CAPD患者临床资料,采用ELASA法检测血清FGF-23和s KL浓度。采用腰椎侧位片评估患者腹主动脉钙化情况,比较腹主动脉非钙化组和腹主动脉钙化组的各项临床指标;用Logistic回归分析法分析患者发生腹主动脉钙化的危险因素;受试者工作特征曲线(ROC)评估FGF-23和s KL预测腹主动脉钙化的敏感度及特异度。结果:147例CAPD患者腹主动脉钙化的发生率为37.41%,腹主动脉钙化与FGF-23水平、s KL水平、年龄、透析龄、碱性磷酸酶(ALP)、血磷水平、三酰甘油(TG)、超敏C反应蛋白(hs CRP)相关。将单因素分析有统计学意义的变量纳入多因素Logistics回归,FGF-23中位水平以上者(2 770.36 pg/ml),其发生腹主动脉钙化的危险度是中位水平及以下者的6.50倍(OR 6.50,95%CI 1.41~29.88);年龄每增加1岁,危险度增加7%(OR 1.07,95%CI 1.03~1.11);血磷1.75 mmol/L者,其发生腹主动脉钙化的危险度是血磷≤1.75 mmol/L者的3.49倍(OR 3.49,95%CI 1.09~11.14)。s KL296.53 pg/ml者,其腹主动脉钙化的危险度是s KL≤296.53 pg/ml者的0.25倍(OR 0.25,95%CI 0.13~0.52)。FGF-23预测腹主动脉钙化的ROC曲线下面积(AUC)为0.96(截点为2 045.14 pg/ml,其敏感度91.0%,特异度96.6%);s KL预测腹主动脉钙化的AUC为0.95(截点为434.78 pg/ml,其敏感度93.3%,特异度94.8%)。结论:CAPD患者腹主动脉钙化与FGF-23水平、s KL水平、年龄、透析龄、ALP、血磷水平、TG、hs CRP相关。血清FGF-23与s KL水平均有助于预测腹主动脉钙化,高FGF-23及低s KL的CAPD患者发生腹主动脉钙化的危险度高。
[Abstract]:Aim: to investigate the relationship between abdominal aortic calcification and serum levels of fibroblast growth factor 23 (FGF-23) and soluble Klotho (sKL) in patients with continuous ambulatory peritoneal dialysis (CAPD). Methods: the clinical data of 147 patients with CAPD were collected and serum FGF-23 and sKL levels were detected by ELASA method. The clinical indexes of abdominal aortic calcification were compared between non-calcified abdominal aorta and calcified abdominal aorta, and the risk factors of abdominal aortic calcification were analyzed by logistic regression analysis. The sensitivity and specificity of FGF-23 and sKL in predicting abdominal aortic calcification were evaluated by operating characteristic curve (ROC). Results the incidence of abdominal aortic calcification was 37.41 in 147 CAPD patients. Abdominal aortic calcification was correlated with FGF-23 level, age, dialysis age, alkaline phosphatase (ALP), serum phosphorus level, triglyceride (TG) and hypersensitive C-reactive protein (hs-CRP). The risk of abdominal aortic calcification was 6.50 times higher than that of those with median level of FGF-23 (2 770.36 pg/ml) in multivariate Logistics regression analysis (OR 6.5095 CI 1.41m29.88), and the risk of abdominal aortic calcification was 6.50 times (OR 6.5095 CI 1.41c29.88), and the risk of abdominal aortic calcification was 6.50 times (OR 6.5095 CI 1.41c 29.88). The risk of abdominal aortic calcification in patients with blood phosphorus 1.75 mmol / L was 3.49 times higher than that in patients with blood phosphorus 鈮，

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