發(fā)布時(shí)間：2018-07-03 18:33

  本文選題：腹膜透析 + 腹主動脈鈣化　； 參考：《腎臟病與透析腎移植雜志》2017年04期

【摘要】：目的:探討持續(xù)非臥床腹膜透析(CAPD)患者腹主動脈鈣化與血清成纖維細(xì)胞生長因子23(FGF-23)和可溶性Klotho(s KL)水平之間的關(guān)系。方法:收集147例CAPD患者臨床資料,采用ELASA法檢測血清FGF-23和s KL濃度。采用腰椎側(cè)位片評估患者腹主動脈鈣化情況,比較腹主動脈非鈣化組和腹主動脈鈣化組的各項(xiàng)臨床指標(biāo);用Logistic回歸分析法分析患者發(fā)生腹主動脈鈣化的危險(xiǎn)因素;受試者工作特征曲線(ROC)評估FGF-23和s KL預(yù)測腹主動脈鈣化的敏感度及特異度。結(jié)果:147例CAPD患者腹主動脈鈣化的發(fā)生率為37.41%,腹主動脈鈣化與FGF-23水平、s KL水平、年齡、透析齡、堿性磷酸酶(ALP)、血磷水平、三酰甘油(TG)、超敏C反應(yīng)蛋白(hs CRP)相關(guān)。將單因素分析有統(tǒng)計(jì)學(xué)意義的變量納入多因素Logistics回歸,FGF-23中位水平以上者(2 770.36 pg/ml),其發(fā)生腹主動脈鈣化的危險(xiǎn)度是中位水平及以下者的6.50倍(OR 6.50,95%CI 1.41~29.88);年齡每增加1歲,危險(xiǎn)度增加7%(OR 1.07,95%CI 1.03~1.11);血磷1.75 mmol/L者,其發(fā)生腹主動脈鈣化的危險(xiǎn)度是血磷≤1.75 mmol/L者的3.49倍(OR 3.49,95%CI 1.09~11.14)。s KL296.53 pg/ml者,其腹主動脈鈣化的危險(xiǎn)度是s KL≤296.53 pg/ml者的0.25倍(OR 0.25,95%CI 0.13~0.52)。FGF-23預(yù)測腹主動脈鈣化的ROC曲線下面積(AUC)為0.96(截點(diǎn)為2 045.14 pg/ml,其敏感度91.0%,特異度96.6%);s KL預(yù)測腹主動脈鈣化的AUC為0.95(截點(diǎn)為434.78 pg/ml,其敏感度93.3%,特異度94.8%)。結(jié)論:CAPD患者腹主動脈鈣化與FGF-23水平、s KL水平、年齡、透析齡、ALP、血磷水平、TG、hs CRP相關(guān)。血清FGF-23與s KL水平均有助于預(yù)測腹主動脈鈣化,高FGF-23及低s KL的CAPD患者發(fā)生腹主動脈鈣化的危險(xiǎn)度高。
[Abstract]:Aim: to investigate the relationship between abdominal aortic calcification and serum levels of fibroblast growth factor 23 (FGF-23) and soluble Klotho (sKL) in patients with continuous ambulatory peritoneal dialysis (CAPD). Methods: the clinical data of 147 patients with CAPD were collected and serum FGF-23 and sKL levels were detected by ELASA method. The clinical indexes of abdominal aortic calcification were compared between non-calcified abdominal aorta and calcified abdominal aorta, and the risk factors of abdominal aortic calcification were analyzed by logistic regression analysis. The sensitivity and specificity of FGF-23 and sKL in predicting abdominal aortic calcification were evaluated by operating characteristic curve (ROC). Results the incidence of abdominal aortic calcification was 37.41 in 147 CAPD patients. Abdominal aortic calcification was correlated with FGF-23 level, age, dialysis age, alkaline phosphatase (ALP), serum phosphorus level, triglyceride (TG) and hypersensitive C-reactive protein (hs-CRP). The risk of abdominal aortic calcification was 6.50 times higher than that of those with median level of FGF-23 (2 770.36 pg/ml) in multivariate Logistics regression analysis (OR 6.5095 CI 1.41m29.88), and the risk of abdominal aortic calcification was 6.50 times (OR 6.5095 CI 1.41c29.88), and the risk of abdominal aortic calcification was 6.50 times (OR 6.5095 CI 1.41c 29.88). The risk of abdominal aortic calcification in patients with blood phosphorus 1.75 mmol / L was 3.49 times higher than that in patients with blood phosphorus 鈮，

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