血清FGF23、FA水平与维持性血液透析患者冠状动脉钙化的关系

Relationship between serum FGF23 and FA level and coronary artery calcification in patients with maintenance hemodialysis

目的研究血清成纤维细胞生长因子23(FGF23)、胎球蛋白A(FA)水平与维持性血液透析患者冠状动脉钙化的关系。方法选择2016年4月~2017年4月西安交通大学第二附属医院收治的维持性血液透析患者97例,所有患者行冠状动脉多层螺旋CT检查,并根据冠状动脉Agaston评分(CACs)将患者分为无钙化组(CACs<10分)21例,轻度钙化组(11分≤CACs<100分)33例,中度钙化组(100分≤CACs<400分)24例,重度钙化组(CACs≥400分)19例。比较各组患者基本资料,各项生化指标水平,并进行相关性分析。结果重度钙化组患者年龄显著高于无钙化组、轻度钙化组、中度钙化组,透析时间长于无钙化组、轻度钙化组、中度钙化组,中度钙化组患者透析时间长于无钙化组,差异均有统计学意义(均P<0.05)。各组糖尿病患病率、高血压患病率和性别构成比较,差异无统计学意义(P>0.05)。无钙化组、轻度钙化组、中度钙化组、重度钙化组血磷、血清FGF23水平呈逐渐升高趋势,而血清FA水平呈逐渐降低趋势,各组间比较差异均有统计学意义(均P<0.05),各组尿素氮、血肌酐、肾小球滤过率、空腹血糖、总胆固醇、三酰甘油、血钙比较,差异无统计学意义(P>0.05)。经Pearson相关性分析可得:维持性血液透析患者冠状动脉钙化程度与年龄、透析时间、血磷、血清FGF23水平均呈正相关,而与血清FA水平呈负相关(均P<0.05)。结论血清FGF23、FA水平与维持性血液透析患者冠状动脉钙化存在密切相关,且随着血清FGF23水平的升高以及FA水平的降低,维持性血液透析患者冠状动脉钙化程度越严重。

Objective To investigate the relationship between serum fibroblast growth factor 23(FGF23)and fetoprotein A(FA)levels and coronary artery calcification in patients with maintenance hemodialysis.Methods From April 2016 to April 2017,97 cases of maintenance hemodialysis patients admitted to the Second Affiliated Hospital of Xi′an Jiaotong University were selected.All patients underwent MSCT,and according to coronary artery Agaston score(CACs),the patients were divided into non-calcification group(CACs<10 points)21 cases,mild calcification group(11 points≤CACs<100 points)33 cases,moderate calcification group(100 points≤CACs<400 points)24 cases,and severe calcification group(CACs>400 points)19 cases.Basic data and biochemical indexes of the patients in each group were compared,and correlation analysis was conducted.Results The age of patients in the severe calcification group was significantly higher than that in the non-calcification group,the mild calcification group and the moderate calcification group,and the duration of dialysis was longer than that in the non-calcification group,the mild calcification group and the moderate calcification group,and the duration of dialysis in the moderate calcification group was longer than that in the non-calcification group,with statistically significant differences(all P<0.05).There was no significant difference in the prevalence of diabetes,hypertension and gender composition among the groups(P>0.05).The levels of serum phosphorus and FGF23 in the non-calcification group,mild calcification group,moderate calcification group and severe calcification group presented a gradually increasing trend,while the level of serum FA presented a gradually decreasing trend,the differences between the groups were statistically significant(all P<0.05).Blood urea nitrogen,serum creatinine,glomerular filtration rate,fasting blood glucose,total cholesterol,triglyceride,and serum calcium were compared between groups,and the differences were not statistically significant(P>0.05).Pearson correlation analysis showed that the degree of coronary artery calcification in patients with maintenance hemodialysis was positively correlated with age,duration of hemodialysis,serum phosphorus and serum FGF23 level,while negatively correlated with serum FA level(all P<0.05).Conclusion Serum FGF23 and FA levels are closely related to coronary artery calcification in patients with maintenance hemodialysis,and with the increase of serum FGF23 level and the decrease of FA level,the degree of coronary artery calcification in patients with maintenance hemodialysis becomes more serious.