维持性血液透析患者血清人成纤维细胞生长因子23水平与血管钙化的关系

Relationship between serum fibroblast growth factor-23 level and vascular calcification in maintenance hemodialysis patients

目的探讨维持性血液透析患者血清人成纤维细胞生长因子23(FGF-23)水平和血管钙化的关系。方法选择2017年1月至2017年12月中山大学附属第八医院收治的92例维持性血液透析患者为研究对象,采用胸部X线摄片判断患者的血管钙化程度。随后,采用双抗体夹心ABC-ELISA法测定患者血清FGF-23水平,并据此采用Spearman法分析血管钙化评分与FGF-23水平的相关性。结果年龄≥60岁、男性、糖尿病患者的中重度血管钙化发生率高于年龄<60岁、女性、非糖尿病患者;与钙化评分<3分的维持性血液透析患者相比,钙化评分≥3分患者每日所服用钙剂剂量较高,故钙磷乘积、血白蛋白等水平也相对较高;血管钙化评分≥3分患者的血清FGF-23水平明显高于钙化评分<3分患者,且血清FGF-23水平与血磷、钙磷乘积以及服用钙剂剂量呈正相关。结论血清FGF-23水平越高,血管钙化程度越严重,临床可以通过调控血磷含量来抑制血清FGF-23水平,从而改善患者血管钙化情况。

Objective To investigate the relationship between serum fibroblast growth factor-23 level and vascular calcification in maintenance hemodialysis patients. Methods Ninty-two patients with maintenance hemodialysis in the Eighth Affiliated Hospital of Sun Yat-sen University from January 2017 to December 2017 were selected as the subjects. Chest X-ray was used to determine the degree of vascular calcification. Subsequently, the serum fibroblast growth factor-23 levels were measured by double antibody sandwich ABC-ELISA, and the relationship between vascular calcification score and fibroblast growth factor-23 level was analyzed by Spearman method. Results The incidences of moderate and severe vascular calcification in patients with age ≥60 years old, male and diabetes mellitus were higher than those in female patients with age <60 years old and non-diabetes mellitus. Compared with patients with calcification score<3 points in maintenance hemodialysis, the patients with calcification score (≥3 points) had higher daily dosage of calcium, so the levels of calcium-phosphorus product and serum albumin were also higher.The serum fibroblast growth factor-23 level of patients with calcification score (≥3 points)was significantly higher than that of patients with calcification score<3 points, and the serum fibroblast growth factor-23 level was positively correlated with serum phosphorus, calcium-phosphorus product and dosage of calcium. Conclusions Serum fibroblast growth factor-23 level is correlated with vascular calcification score. The higher the serum fibroblast growth factor-23 level, the more serious the vascular calcification will be. Clinically, serum fibroblast growth factor-23 level can be inhibited by regulating blood phosphorus content to improve the vascular calcification.