本文選題：成纖維細(xì)胞生長(zhǎng)因子　切入點(diǎn)：Klotho蛋白　出處：《中南大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年09期 　論文類(lèi)型：期刊論文

【摘要】：目的:分析維持性血液透析患者血清鈣、磷及成纖維細(xì)胞生長(zhǎng)因子23(fibroblast growth factor,FGF23)、Klotho蛋白水平,探討慢性腎病礦物質(zhì)及骨代謝異常(chronic kidney disease-mineral and bone disorder,CKD-MBD)患者血清FGF23、Klotho蛋白水平變化與心血管系統(tǒng)并發(fā)癥的關(guān)系。方法:回顧性分析中南大學(xué)湘雅醫(yī)院CKD-MBD未透析患者(NHD組)、CKD-MBD規(guī)律血液透析患者(HD組)及CKD-MBD伴繼發(fā)性甲狀旁腺功能亢進(jìn)(secondary hyperparathyroidism,SHPT)伴腺瘤樣增生患者(SHPT組)各60例的MBD及心臟損傷發(fā)病情況,比較血液透析對(duì)患者病情的影響。同期收集體檢中心體檢健康的30例對(duì)象為對(duì)照組,記錄其基本情況、收集鈣、磷、全段甲狀旁腺素(i PTH)等鈣磷代謝指標(biāo)及心臟彩超檢查結(jié)果。通過(guò)酶聯(lián)免疫吸附試驗(yàn)(enzyme-linked immunosorbent assay,ELISA)檢測(cè)各組血清FGF23和Klotho蛋白情況,比較各組之間鈣磷代謝相關(guān)生化指標(biāo)、左室肥厚、左室擴(kuò)大及心臟瓣膜異位鈣化之間差異,分析上述指標(biāo)間相關(guān)性,明確CKD-MBD患者心血管損傷的相關(guān)因素及其與FGF23蛋白和Klotho蛋白水平的關(guān)系。結(jié)果:維持性血液透析患者尤其是伴有SHPT的血液透析患者血清FGF23水平明顯升高,而血清Klotho蛋白水平明顯降低(P0.01)。FGF23蛋白水平降低者發(fā)生異位鈣化風(fēng)險(xiǎn)升高(OR=4.667);Klotho蛋白水平降低者發(fā)生心肌肥厚風(fēng)險(xiǎn)升高(OR=3.496)。在慢性腎病患者異位鈣化診斷中的血清FGF23蛋白水平ROC曲線下面積為0.778(P0.01);血清Klotho蛋白水平ROC曲線下面積為0.715(P0.01)。結(jié)論:血清FGF23增多、Klotho蛋白減少是CKD心臟損傷的危險(xiǎn)因素。FGF23和Klotho蛋白可作為診斷和預(yù)測(cè)CKD-MBD患者心臟異位鈣化的臨床指標(biāo)。
[Abstract]:Objective: to analyze the levels of serum calcium, phosphorus and fibroblast growth factor (FGF23) protein in patients with maintenance hemodialysis. To investigate the relationship between the changes of serum FGF23 Klotho protein and cardiovascular system complications in patients with chronic kidney disease-mineral and bone disordern CKD-MBD. Methods: retrospective analysis was made on the changes of CKD-MBD in CKD-MBD patients without dialysis in Xiangya Hospital, Central South University. The incidence of MBD and cardiac injury in 60 patients with regular hemodialysis and 60 patients with secondary hyperparathyroidism and adenomatous hyperplasia. To compare the effect of hemodialysis on the patients' condition. 30 healthy subjects collected from the physical examination center at the same time were taken as the control group, and their basic information was recorded, and calcium and phosphorus were collected. Serum FGF23 and Klotho protein were detected by enzyme linked immunosorbent assay (Elisa), and calcium and phosphorus metabolism indexes were compared between groups, left ventricular hypertrophy, left ventricular hypertrophy (LVH), and left ventricular hypertrophy (LVH) by enzyme linked immunosorbent assay (Elisa). The differences between left ventricular dilatation and cardiac valve ectopic calcification were analyzed. Results: the level of serum FGF23 in maintenance hemodialysis patients, especially in hemodialysis patients with SHPT, was significantly higher than that in patients with SHPT. However, the serum Klotho protein level was significantly decreased in patients with decreased protein level of P0.01U. FGF23. The risk of ectopic calcification was increased. The risk of myocardial hypertrophy was increased in patients with decreased serum Klotho protein level. Serum FGF23 protein hydration in the diagnosis of ectopic calcification in patients with chronic nephropathy. The area under the flat ROC curve was 0.778m P0.01A and the area under the serum Klotho protein level ROC curve was 0.715p0.01.Conclusion: the increase of serum FGF23 and the decrease of Klotho protein are the risk factors of CKD heart injury. FGF23 and Klotho proteins can be used as clinical indexes to diagnose and predict cardiac ectopic calcification in CKD-MBD patients.
【作者單位】： 中南大學(xué)湘雅醫(yī)院腎內(nèi)科;
【基金】：國(guó)家自然科學(xué)基金(81470933)~~
【分類(lèi)號(hào)】：R54;R692.5

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