冠心病患者血清FGF23水平与血管内皮功能和冠状动脉病变程度相关性分析

Correlation analysis of serum FGF23 level with vascular endothelial function and severity of coronary artery in patients with coronary heart disease

目的探讨成纤维细胞生长因子23(FGF23)与冠心病患者血管内皮功能和冠状动脉病变程度的相关性。方法纳入经冠状动脉造影证实的214例冠心病患者,根据肱动脉血流介导性舒张(FMD)分为FMD损伤组(138例,FMD<6%)和FMD正常组(76例,6%≤FMD<20%)。采用ELISA法测定患者血清FGF23、一氧化氮(NO)和内皮素1(ET-1)水平。分析冠心病患者FGF23与内皮功能相关指标NO和ET-1的相关性。采用多因素logistic回归分析冠心病患者血管内皮功能损伤的危险因素。结果 FMD损伤组吸烟史比例、TG、DBP和LDL-C均高于FMD正常组(P<0.05),而HDL-C低于FMD正常组(P<0.05)。FMD损伤组血清FGF23水平高于FMD正常组(P<0.05)。冠心病患者血清FGF23与NO水平呈负相关(r=-0.312,P<0.01),而与ET-1水平呈正相关(r=0.492,P<0.01)。多支血管病变组患者血清FGF23水平高于单支血管病变组(P<0.05)。冠心病患者血清FGF23水平与Gensini评分呈正相关(r=0.674,P<0.01)。多因素logistic回归分析结果显示,高水平FGF23是冠心病患者血管内皮功能损伤的独立危险因素[OR=1.223,95%CI(1.400~2.610),P<0.01]。结论 FGF23与冠心病患者血管内皮功能损伤相关,FGF23水平可在一定程度上反映冠心病的病变程度。高水平FGF23可能是血管内皮功能损伤的独立危险因素。

Objective To explore the correlation between fibroblast growth factor 23(FGF23) and vascular endothelial function and severity of coronary artery in the patients with coronary heart disease(CHD).Methods A total of 214 patients with CHD confirmed by coronary angiography were included.According to brachial artery flow-mediated dilation(FMD),the patients were divided into two groups of A(138 cases, FMD <6%) and B(76 cases, 6%≤FMD <20%).Serum levels of FGF23,nitric oxide(NO) and endothelin 1(ET-1) were determined by ELISA.The correlation between FGF23 and endothelial function-related indexes NO and ET-1 in the patients was analyzed.Multivariate logistic regression was used to analyze the risk factors for vascular endothelial function damage in the patients with CHD.Results The proportion of the patients with smoking history, and levels of TG,DBP and LDL-C in group A were higher than those in group B(P<0.05),while HDL-C was lower than that in group B(P<0.05).Serum level of FGF23 in group A was higher than that in group B(P<0.05).FGF23 level in the patients with CHD was negatively correlated with NO level(r=-0.312,P<0.01),and positively correlated with ET-1 level(r=0.492,P<0.01).Serum level of FGF23 in the patients with multi-vessel disease was higher than that in the patients with single vessel with single vessel disease(P<0.05).Serum level of FGF23 was positively correlated to Gensini score in CHD patients(r=0.674,P<0.01).Multivariate logistic regression analysis showed that high level of FGF23 was the independent risk factor for vascular endothelial function injury [OR=1.223,95%CI(1.400-2.610),P<0.01].Conclusion Serum level of FGF23 is related to the damage of vascular endothelial function in the patients with CHD,which can reflect the severity of CHD to a certain extent.High level of FGF23 may be an independent risk factor for vascular endothelial function injury.