摘要
目的探究维持性血液透析(MHD)患者血清成纤维细胞生长因子(FGF⁃23)、胰岛素样生长因子⁃1(IGF⁃1)、全身免疫炎症指数(SII)与营养不良的相关性及临床预测价值。方法选取2021年4月至2022年9月于合肥市第二人民医院肾内科行MHD治疗的患者803例的临床资料,根据其是否存在营养不良分为营养不良组(201例)、非营养不良组(602例)。比较两组患者血清FGF⁃23、IGF⁃1、SII指数及一般资料差异,采用二元logistics回归分析影响营养不良的因素,建立受试者工作特征(ROC)曲线,评估血清FGF⁃23、IGF⁃1、SII指数单独、联合对营养不良的预测价值,计算血清FGF⁃23、IGF⁃1、SII指数最佳预测临界值。结果与非营养不良组相比,营养不良组血清FGF⁃23、SII指数更高,IGF⁃1水平更低,差异有统计学意义(t=14.499、-15.291、8.313,P<0.05)。与非营养不良组相比,营养不良组体质指数更低,透析时间更长,血肌酐、红细胞水平以及上臂肌围更低,差异有统计学意义(t=8.070、-5.593、-4.896、-15.999,P<0.05)。logistics回归分析显示体质指数、透析时间、上臂肌围、FGF⁃23、IGF⁃1、SII指数是营养不良发生的影响因素(P<0.05)。FGF⁃23、IGF⁃1、SII指数单独、联合预测预后不良的曲线下面积分别为0.779、0.778、0.672、0.947,FGF⁃23、IGF⁃1、SII指数单独、联合预测营养不良均有一定临床参考价值。结论血清FGF⁃23、IGF⁃1、SII指数是MHD患者营养不良发生的独立影响因素,三者单独、联合预测营养不良发生均有一定临床参考价值。
Objective To explore the correlation between serum fibroblast growth factor(FGF⁃23),insulin⁃like growth factor⁃1(IGF⁃1),systemic immune inflammation index(SII),and malnutrition in patients with maintenance hemodialysis(MHD).Methods The clinical data of 803 patients who underwent MHD treatment in the Department of Nephrology,Hefei Second People's Hospital from April 2021 to September 2022 were analyzed,and they were divided into a malnutrition group(201 cases)and a non⁃malnutrition group according to whether they were malnourished(602 cases).The differences in serum FGF⁃23,IGF⁃1,SII index and general data were compared between the two groups,the factors affecting malnutrition were analyzed by binary logistic regression,and the receiver operating characteristic(ROC)curve was established.The predictive value of serum FGF⁃23,IGF⁃1,SII index alone or in combination on malnutrition was evaluated.The optimal predictive threshold value of serum FGF⁃23,IGF⁃1,and SII index was calculated.Results Compared with the non⁃malnutrition group,the malnutrition group had higher serum FGF⁃23,SII index,and lower IGF⁃1 levels,with a statistically significant difference(t=14.499,-15.291,8.313,P<0.05).Compared with the non⁃malnutrition group,the malnutrition group had lower body mass index,longer dialysis time,lower blood creatinine,red blood cell levels,and lower upper arm muscle circumference,with a statistically significant difference(t=8.070,-5.593,-4.896,-15.999,P<0.05).Logistic regression analysis showed that body mass index,dialysis time,upper arm muscle circumference,FGF⁃23,IGF⁃1,and SII index were influential factors for the occurrence of malnutrition(P<0.05).The area under the curve for predicting poor prognosis with FGF⁃23,IGF⁃1,and SII index alone or in combination was 0.779,0.778,0.672,and 0.947,respectively.Conclusion Serum FGF⁃23,IGF⁃1,and SII index are independent influencing factors for the occurrence of malnutrition in MHD patients.The three factors alone or in combination have certain clinical reference value in predicting the occurrence of malnutrition.
作者
张玲
刘莉
王娜娜
ZHANG Ling;LIU Li;WANG Nana(Department of Nephrology,the Second People's Hospital of Hefei,Hefei,Anhui,China,230011)
出处
《分子诊断与治疗杂志》
2023年第9期1579-1582,共4页
Journal of Molecular Diagnostics and Therapy
基金
安徽省自然科学基金项目(2008085QH359)。
关键词
维持性血液透析
纤维细胞生长因子
胰岛素样生长因子⁃1
全身免疫炎症指数
营养不良
Maintenance hemodialysis
Fibroblast growth factor
Insulin like growth factor 1
Systemic immune inflammation index
Protein energy consumption