[1]杨 雄,尹爱萍.慢性肾脏病不同分期患者血清多项骨代谢指标变化与成纤维细胞生长因子23的相关性分析[J].现代检验医学杂志,2019,34(04):58-61.[doi:10.3969/j.issn.1671-7414.2019.04.014]
　YANG Xiong.,YIN Ai-ping.Analysis of the Correlation between Serum Bone Metabolism and Fibroblast Growth Factor 23 in Patients with Chronic Kidney Disease at Different Stages[J].Journal of Modern Laboratory Medicine,2019,34(04):58-61.[doi:10.3969/j.issn.1671-7414.2019.04.014]
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慢性肾脏病不同分期患者血清多项骨代谢指标变化与成纤维细胞生长因子23的相关性分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第34卷
期数:
2019年04期
页码:
58-61
栏目:
论著
出版日期:
2019-08-20

文章信息/Info

Title:
Analysis of the Correlation between Serum Bone Metabolism and Fibroblast Growth Factor 23 in Patients with Chronic Kidney Disease at Different Stages
文章编号:
1671-7414(2019)04-058-05
作者:
杨 雄1; 2; 尹爱萍3
(1.神木市医院综合内科,陕西神木 719300; 2.西安交通大学医学院,西安 710061; 3.西安交通大学第一附属医院肾内科,西安 710061)
Author(s):
YANG Xiong1.2; YIN Ai-ping3
(1.General Internal Medicine Department of Shenmu Hospital, Shaanxi Shenmu 719300,China; 2.Medical College of Xi'an Jiaotong University, Xi'an 710061,China; 3.Department of Nephrology,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)
关键词:
慢性肾脏病;  矿物质骨代谢;  成纤维细胞生长因子
分类号:
R692; R392.11
DOI:
10.3969/j.issn.1671-7414.2019.04.014
文献标志码:
A
摘要:
目的 探究慢性肾脏病(CKD)3期～5期患者矿物质骨代谢指标变化及与成纤维细胞生长因子(FGF)23的相关性。方法 选取神木市医院综合内科2016年1月～2018年12月收治的100例慢性肾脏病患者,根据CKD分期标准分为CKD 3期(n=33),CKD 4期(n=32)和CKD 5期(n=35),所有患者检测血生化指标、矿物质代谢指标和FGF23水平,分析相关性。结果 随着CKD患者分期升高,血磷(P)、血镁(Mg)、全段甲状旁腺激素(iPTH)、骨钙素(OC)、骨型碱性磷酸酶(BSALP)、抗酒石酸酸性磷酸酶5b(TRACP-5b)及FGF23水平均显著升高,差异有统计学意义(F=14.769～38.176,均P<0.001),而血钙(Ca),Klotho蛋白和25羟基维生素D(25-OH-VD)均显著降低,差异有统计学意义(F=16.543～25.539,均P<0.001),不同分期CKD患者间比较差异显著(F=6.916,P<0.05)。CKD 3～5期患者FGF23平均浓度水平与疾病类型、临床分期、血P,Mg,iPTH,OC,BSALP和TRACP-5b存在明显正相关性(r=0.948～10.994,均P<0.05),而与血Ca,Klotho蛋白、25-OH-VD存在明显负相关性(r=-6.755～2.063,均P<0.05)。以CKD 3～5期患者FGF23平均浓度作为因变量,回归分析显示,血Ca,P,Mg,iPTH为FGF23的独立影响因素(B=-0.533～6.075,SE=0.070～0.286,χ2=-6.844～8.436,均P<0.05)。结论 CKD 3～5期患者矿物质骨代谢紊乱逐渐加重,且CKD3-5期患者骨代谢紊乱与FGF23存在明显相关性。
Abstract:
Objective To investigate the relationship between mineral bone metabolism and fibroblast growth factor(FGF)23 in stage 3～5 patients with chronic kidney disease(CKD).Methods From January 2016 to December 2018,100 patients with chronic kidney disease were selected.According to the criteria of CKD staging,they were divided into three stages:CKD 3 stage(n=33),CKD 4 stage(n=32)and CKD 5 stage(n=35).Blood biochemical indexes,mineral metabolism indexes and FGF23 levels were measured in all patients and the correlation was analyzed.Results With the staging of CKD patients,the levels of serum phosphorus(P),serummagnesium(Mg),the whole parathyroid hormone(iPTH),osteocalcin(OC),bone type alkaline phosphatase(BSALP),tartrate-resistant acid phosphatase 5b(TRACP-5b)and FGF23 increased significantly(F=14.769～38.176,all P<0.001),while serum calcium(Ca),Klotho protein and 25-hydroxyvitamin D(25-OH-VD)decreased significantly(F=16.543～25.539,all P<0.001)respectively.There was significant difference between different stages of chronic nephropathy(F=6.916,P<0.05).The average concentration of FGF23 in CKD 3～5 patients was positively correlated with type of disease,clinical stage,blood P,blood Mg,iPTH,OC,BSALP and TRACP-5b(r=0.948～10.994,all P<0.05),but was significantly negative correlated with blood Ca,Klotho protein and 25-OH-VD(r=-6.755～-2.063,all P<0.05).Regression analysis showed thatserum Ca,P,Mg and iPTH were independent influencing factors of fibroblast growth factor 23(B=-0.533～6.075,SE=0.070～0.286,χ2=-6.844～8.436,allP<0.05)。Conclusion Metabolism disorder of mineralbone in patients with CKD 3～5 was gradually aggravated,and it had obvious correlation with FGF23.FGF23 can be used as an effective indicator of bone metabolism disorder in CKD patients.

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备注/Memo

备注/Memo:
基金项目:陕西省卫生厅科研项目(2012D65)。 作者简介:杨 雄(1978-),男,副主任医师,研究方向:肾脏病学,E-mail:shenyxiong@163.com。 通讯作者:尹爱萍,E-mail:aipingy@126.com。收稿日期:2019-03-06 修回日期:2019-05-06
更新日期/Last Update: 2019-07-30