终末期肾病病人血清FGF-23与心血管钙化的关系

RELATIONSHIP BETWWEN SERUM FIBROBLAST GROWTH FACTOR-23 AND VASCULAR CALCIFICATION IN PATIENTS WITH END-STAGE RENAL DISEASE

目的探讨终末期肾病(ESRD)病人血清成纤维细胞生长因子23(FGF-23)水平与心血管钙化的关系。方法 ESRD病人60例,应用彩色多普勒超声心动图、侧位腹部X线平片对心脏和腹主动脉钙化进行定性检测,酶联免疫吸附法检测FGF-23,实验室常规方法测定血清肌酐(Scr)、钙(Ca)、磷(P)、碱性磷酸酶(ALP)、总胆固醇(TC)、三酰甘油(TG)、血红蛋白(HB),电化学发光法测定全段甲状旁腺激素(iPTH)。以40例健康查体者为对照组。结果 ESRD病人血清FGF-23水平较对照组显著升高,差异有显著性(t=7.50,P<0.01)。ESRD病人血清FGF-23水平与Scr、P、iPTH、ALP呈正相关(r=0.411～0.675,P<0.01),与Ca、TC、TG、HB无相关性(r=-0.113～-0.012,P>0.05)。心血管钙化组血清FGF-23水平显著高于非钙化组(t=5.40,P<0.01)。结论 ESRD病人血清FGF-23水平升高与心血管钙化的发生发展密切相关。

Objective To study the relationship between serum fibroblast growth factor-23 （FGF-23） and cardiovascular calcification in patients with end-stage renal disease （ESRD）. Methods A total of 60 ESRD patients were included in this study, the calcification of their abdominal aortas and cardiac valves was qualitatively assessed by both lateral-position plain radiography of abdomen and echocardiography, and FGF-23 by enzyme-linked immunosorbent assay （ELISA）. A routine laboratory test was done for detection of serum creatinine （Scr）, calcium （Ca）, phosphorus （P）, alkaline phosphotase （ALP）, total cholesterol （TC）, he- moglobin （HB）, and immunoreactive parathyroid hormone （iPTH） was detected by electrochemilluminescence method. Forty in- dividuals who joined physical examination were served as controls. Results The levels of FGF-23 in ESRD patients were higher than that in the control, the difference was significant （t = 7.50, P 〈0.01）. A correlation analysis indicated that serum FGF-23 level was positively correlated with Scr, P, iPTH and ALP （r=0. 411-0. 675 ,P〈0.01）, and not correlated with serum Ca, TC, TG, and HB （r= -0. 113-- 0. 012, P 〉0.05）. Serum FGF-23 was higher in ESRD patients with cardiovascular calcification than those without （t=5.40,P〈0.01）. Conclusion The rising of serum FGF-23 in ESRD patients is closely related with oc- currence and development of cardiovascular calcification.