慢性肾功能衰竭患者血清 FGF-23、血钙及血磷水平对左心功能的影响

Effect of FGF-23,serum calcium and phosphorus levels of patients with chronic renal failure on the left ventricular function

目的：探讨慢性肾功能衰竭（CRF）患者血清成纤维细胞生长因子-23（FGF-23）、血钙及血磷水平对左心功能的影响。方法随机选择2012年6月至2015年6月慢性肾功能衰竭患者148例，分为透析组88例和非透析组60例，比较两组间各生化指标及左心功能指标的差异，按四分位数法将所有患者血清 FGF-23水平分为4个等级，比较各等级间心功能指标的差异，分析血清 FGF-23与心功能间的相关性。结果透析组 FGF-23[（199.9±60.2）pg/ ml]、血钙[（2.2±0.2）mmol/ L]、血磷[（2.5±0.7）mmol/ L]与非透析组比较差异有统计学意义（P 〈0.05）。4个等级 CRF 患者左心室射血分数（LVEF）、心肌功能指数（MPI）、左室肥大（LVH）比较差异均有统计学意义（P 〈0.05），并且 CRF 患者血清 FGF-23与 LVEF 呈负相关（r =-0.623，P 〈0.05），与 MPI 呈正相关（r =0.503，P 〈0.05）。结论慢性肾功能衰竭患者血清 FGF-23、血钙及血磷水平对 LVEF、MPI 及 LVH 等指标影响明显，从而对左心功能具有显著影响。

Objective To study the effect of FGF-23,serum calcium and phosphorus levels of patients with chronic renal failure on the left ventricular function. Methods From June 2012 to June 2015,148 patients with chronic renal failure were selected randomly,and divided into dialysis group with 88 cases and non-dialysis group with 60 cases. The differences of biochemical indicators and left heart function indicators between the two groups were compared. Then all patients were divided into four levels based on the serum level of FGF-23 by the quartile method,the difference of left cardiac function indicators between the four levels were compared,and the correlation between serum FGF-23 and cardiac function was investigated. Results FGF-23 of dialysis group was（199. 9 ± 60. 2）pg / ml,serum calcium was（2. 2 ± 0. 2）mmol/ L,serum phosphorus was（2. 5 ± 0. 7）mmol/ L,in comparation with non-dialysis group,the differences were significant（P 〈 0. 05）. The difference of LVEF,MPI,LVH between 4 levels patients showed significant difference（P 〈 0. 05）. There were significant negative correlation of serum FGF-23 with LVEF（r = - 0. 623,P 〈 0. 05）,and positive correlation of serum FGF-23 with MPI（r =0. 503,P 〈 0. 05）. Conclusions FGF-23,serum calcium and phosphorus levels of patients with chron-ic renal failure has remarkable effects on LVEF,MPI and LVH,and has effect on the left ventricular function.