维持性血液透析患者FGF⁃23、sclerostin及sTWEAK与冠状动脉钙化的相关性

Correlation of FGF⁃23,sclerostin and sTWEAK with coronary artery calcification in maintenance hemodialysis patients

目的研究维持性血液透析患者成纤维细胞生长因子23(FGF⁃23)、血清骨硬化蛋白(sclerostin)及可溶性肿瘤坏死因子样凋亡微弱诱导剂(sTWEAK)水平变化与冠状动脉钙化的相关性。方法选取2019年11月至2020年12月重庆市大足区人民医院收治的148例维持性血液透析患者,根据有无合并冠状动脉钙化将其分为合并组(n=59)、未合并组(n=89)。比较两组以及不同钙化程度患者FGF⁃23、sclerostin及sTWEAK水平,分析影响维持性血液透析患者冠状动脉钙化的单因素、多因素。结果合并组FGF⁃23、sclerostin水平高于未合并组,sTWEAK水平低于未合并组,差异均有统计学意义(P<0.05)。FGF⁃23、sclerostin水平:轻度钙化<中度钙化<重度钙化,sTWEAK水平:轻度钙化>中度钙化>重度钙化,差异均有统计学意义(P<0.05)。血钙、FGF⁃23、Sclerostin、sTWEAK为影响胶质瘤患者预后的单因素(P<0.05)。多因素Logistic回归模型分析结果显示,血钙、FGF⁃23、Sclerostin、sTWEAK为影响维持性血液透析患者冠状动脉钙化的多因素独立危险因素(P<0.05)。结论FGF⁃23、Sclerostin、sTWEAK水平随着冠状动脉钙化程度的不同而变化,临床可根据其水平变化作为参考依据。

Objective To study the correlation between fibroblast growth factor-23(FGF-23),serum bone sclerostin(sclerostin)and soluble tumor necrosis factor like weak apoptosis inducer(sTWEAK)levels and coronary artery calcification in maintenance hemodialysis patients. Methods The clinical data of148 maintenance hemodialysis patients treated in Chongqing Dazu District People ’s Hospital from November2019 to December 2020 were selected. According to the presence or absence of coronary artery calcification,they were divided into the study group(n=59)and the control group(n=89). The levels of FGF-23,sclerostin and sTWEAK in patients with different degrees of calcification in the two groups were compared,and the single factors and multiple factors that affected coronary artery calcification in maintenance hemodialysis patients were analyzed. Results The level of FGF-23 and sclerostin in the study group was higher than that in the control group,while the level of sTWEAK was lower than that in the control group,the differences were all statistically significant(P<0.05). FGF-23 and sclerostin levels:mild calcification < moderate calcification <severe calcification,sTWEAK level:mild calcification > moderate calcification > severe calcification,the difference was statistically significant(P<0.05). The age,gender,hypertension and other single factors that did not affect coronary artery calcification in maintenance hemodialysis patients(P>0.05). Serum calcium,FGF-23,Sclerostin,and s TWEAK were the single factors affecting the prognosis of patients with glioma(P<0.05).The results of multivariate Logistic regression model analysis showed that serum calcium,FGF-23,Sclerostin and s TWEAK were independent multivariate risk factors for coronary artery calcification in maintenance hemodialysis patients(P<0.05). Conclusion The levels of FGF-23,Sclerostin,and s TWEAK vary with the degree of coronary artery calcification,and the clinical level can be used as a reference basis.