慢性肾脏病非透析患者FGF23与钙磷代谢相关性研究

发布时间：2018-03-19 15:05

本文选题：FGF23　切入点：慢性肾脏病　出处：《广西医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：研究不同分期慢性肾脏病非透析患者FGF23水平变化及与钙磷代谢的相关关系。方法：测定137例我院慢性肾脏病非透析患者及35名健康对照者血清成纤维生长因子23（FGF23）及其相关调控因子Klotho蛋白、1,25（OH）2VitD3、全段甲状旁腺激素（iPTH）、血磷、血钙、碱性磷酸酶（ALP）等水平，并收集相关临床资料。通过多元逐步线性回归分析总体慢性肾脏病患者FGF23的相关影响因素。结果：对照组及CKD1-2期，3期、4期、5期FGF23中位数水平分别为15.37pg/ml、15.67pg/ml、22.86pg/ml、37.33pg/ml、63.48pg/ml，从CKD3期开始FGF23较对照组升高差异有统计学意义（均P0.05）；FGF23相关调控因子iPTH升高及1,25（OH）2VitD3降低从CKD3开始较对照组差异有统计学意义（均P0.05），，血清Klotho蛋白、血磷升高及血钙降低从CKD4期开始较对照组差异有统计学意义（均P0.05）。多元逐步线性回归提示估算肾小球滤过率（eGFR）、血磷、Klotho蛋白、高密度脂蛋白（HDL）是FGF23的独立影响因素。结论：CKD患者FGF23水平改变早于血钙、血磷、Klotho蛋白，或可作为提示CKD早期钙磷代谢紊乱的敏感指标；eGFR、血磷、Klotho蛋白、HDL是FGF23的独立影响因素。
[Abstract]:Objective: to study the changes of FGF23 level and its correlation with calcium and phosphorus metabolism in non-dialysis patients with chronic kidney disease at different stages. Methods: the levels of serum fibroblast growth factor 23 FGF23 and its related regulatory factor Klotho 2 VitD 3 in 137 patients with chronic kidney disease and 35 healthy controls were measured, and the levels of total parathyroid hormone, phosphorus, serum calcium and alkaline phosphatase (ALP) were measured. Correlation factors of FGF23 in patients with chronic kidney disease were analyzed by multiple stepwise linear regression analysis. Results: the median levels of FGF23 in the control group and the control group were 15.37pg / ml 15.67pgml / ml 15.86pg / ml 22.86pg / ml = 37.33pg / ml, 63.48pg / ml respectively. There was significant difference between the control group and the control group (P0.05FGF23related regulatory factor iPTH increased and 1225OFGF2Vit D3 decreased from the CKD3 stage to the control group. The difference was statistically significant (P 0.05, P < 0.05). The serum Klotho protein, The increase of serum phosphorus and the decrease of serum calcium were significantly different from those of the control group from the stage of CKD4 (all P 0.05). The multiple stepwise linear regression suggested that the estimation of glomerular filtration rate (GFR), serum phosphorous Klotho protein (Klotho protein) and high density lipoprotein (HDL) were independent influencing factors of FGF23. Conclusion the change of FGF23 level in patients with FGF23 is earlier than that in serum calcium and phosphorus, which may be a sensitive index for indicating the disorder of calcium and phosphorus metabolism in the early stage of CKD. The serum Klotho protein may be an independent influencing factor of FGF23.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692

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