血液透析患者FGF23水平与钙磷代谢的相关性分析

Analysis of Correlation between FGF23 Level and Calcium and Phosphorus Metabolism in Hemodialysis Patients

目的探讨血液透析患者成纤维细胞生长因子23(fibroblast growth factor 23,FGF23)水平与钙磷代谢的相关性。方法选取90例维持性血液透析患者及60例健康体检者作为研究对象,根据甲状旁腺激素(parathyroid hormone,PTH)水平,将维持性血液透析患者分为A组(PTH<300pg/mL)、B组(PTH 300~500pg/mL)、C组(PTH>500pg/mL),检测和比较各组血清FGF23、1,25-二羟活性维生素D3[1,25-(OH)2D3]、PTH、血钙、血磷、碱性磷酸酶、白蛋白等指标浓度。结果与健康体检者相比,血液透析患者logFGF23水平明显升高,log1,25-(OH)2D3水平显著降低,差异有统计学意义(P<0.05);与A组相比,C组logFGF23水平明显升高,差异有统计学意义(P<0.05);logFGF23水平与logPTH、血磷、logALP呈正相关性,与log1,25-(OH)2D3呈负相关性。结论血液透析患者血清FGF23水平明显升高,与PTH、血磷、ALP呈正相关,与1,25-(OH)2D3呈负相关。

Objective To investigate the correlation between the level of fibroblast growth factor 23 （FGF23） and calcium and phosphorus metabolism in hemodialysis patients. Methods 90 patients with maintenance hemodialysis and 60 healthy physical examiners were selected as the study subjects. Patients with maintenance hemodialysis were divided into group A （ PTH 〈 300pg/ ml）, group B（ PTH300 -500pg/mL）and group C （PTH 〉 500pg/mL）according to the parathyroid hormone level（PTH）. The con- centrations of serum FGF23,1,25-dihydroxy active vitamin D3 （ 1,25- （OH） ： D 3 ）, PTH, blood calcium, blood phosphorus, alkaline phosphatase and albumin were detected and compared. Results Compared with healthy physical examiners, the level of logFGF23 in hemodialysis patients increased significantly, while the level of logl, 25- （ OH ） ： D 3 in hemodialysis patients decreased significantly（ P 〈 0. 05 ） ;Compared with group A, the level of logFGF23 in group C was significantly higher（ P 〈 0. 05 ） ;The level of log- FGF23 was positively correlated with logPTH, blood phosphorus and logALP,and negatively correlated with logl ,25-（OH） ：D3. Conclusion The serum FGF23 level was significantly increased in hemodialysis patients, which was positively correlated with PTH,blood phosphorus and ALP, and negatively correlated with 1,25-（OH）2D3.