本文選題：FGF23　切入點(diǎn)：慢性腎臟病　出處：《廣西醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：研究不同分期慢性腎臟病非透析患者FGF23水平變化及與鈣磷代謝的相關(guān)關(guān)系。 方法：測(cè)定137例我院慢性腎臟病非透析患者及35名健康對(duì)照者血清成纖維生長(zhǎng)因子23（FGF23）及其相關(guān)調(diào)控因子Klotho蛋白、1,25（OH）2VitD3、全段甲狀旁腺激素（iPTH）、血磷、血鈣、堿性磷酸酶（ALP）等水平，并收集相關(guān)臨床資料。通過多元逐步線性回歸分析總體慢性腎臟病患者FGF23的相關(guān)影響因素。 結(jié)果：對(duì)照組及CKD1-2期，3期、4期、5期FGF23中位數(shù)水平分別為15.37pg/ml、15.67pg/ml、22.86pg/ml、37.33pg/ml、63.48pg/ml，從CKD3期開始FGF23較對(duì)照組升高差異有統(tǒng)計(jì)學(xué)意義（均P0.05）；FGF23相關(guān)調(diào)控因子iPTH升高及1,25（OH）2VitD3降低從CKD3開始較對(duì)照組差異有統(tǒng)計(jì)學(xué)意義（均P0.05），，血清Klotho蛋白、血磷升高及血鈣降低從CKD4期開始較對(duì)照組差異有統(tǒng)計(jì)學(xué)意義（均P0.05）。多元逐步線性回歸提示估算腎小球?yàn)V過率（eGFR）、血磷、Klotho蛋白、高密度脂蛋白（HDL）是FGF23的獨(dú)立影響因素。 結(jié)論：CKD患者FGF23水平改變?cè)缬谘}、血磷、Klotho蛋白，或可作為提示CKD早期鈣磷代謝紊亂的敏感指標(biāo)；eGFR、血磷、Klotho蛋白、HDL是FGF23的獨(dú)立影響因素。
[Abstract]:Objective: to study the changes of FGF23 level and its correlation with calcium and phosphorus metabolism in non-dialysis patients with chronic kidney disease at different stages. Methods: the levels of serum fibroblast growth factor 23 FGF23 and its related regulatory factor Klotho 2 VitD 3 in 137 patients with chronic kidney disease and 35 healthy controls were measured, and the levels of total parathyroid hormone, phosphorus, serum calcium and alkaline phosphatase (ALP) were measured. Correlation factors of FGF23 in patients with chronic kidney disease were analyzed by multiple stepwise linear regression analysis. Results: the median levels of FGF23 in the control group and the control group were 15.37pg / ml 15.67pgml / ml 15.86pg / ml 22.86pg / ml = 37.33pg / ml, 63.48pg / ml respectively. There was significant difference between the control group and the control group (P0.05FGF23related regulatory factor iPTH increased and 1225OFGF2Vit D3 decreased from the CKD3 stage to the control group. The difference was statistically significant (P 0.05, P < 0.05). The serum Klotho protein, The increase of serum phosphorus and the decrease of serum calcium were significantly different from those of the control group from the stage of CKD4 (all P 0.05). The multiple stepwise linear regression suggested that the estimation of glomerular filtration rate (GFR), serum phosphorous Klotho protein (Klotho protein) and high density lipoprotein (HDL) were independent influencing factors of FGF23. Conclusion the change of FGF23 level in patients with FGF23 is earlier than that in serum calcium and phosphorus, which may be a sensitive index for indicating the disorder of calcium and phosphorus metabolism in the early stage of CKD. The serum Klotho protein may be an independent influencing factor of FGF23.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R692

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