CAJ | 학술논문

目的：探讨维持性血液透析( maintenance hemodialysis,MHD)患者发生透中低血压( intradialytic hypotension, IDH)与血清中可溶性klotho(soluble klotho,sKl)和成纤维细胞生长因子23(fibroblast growth factor23,FGF23)之间的关系。方法：横断面收集MHD患者病情资料,根据最近1个月内透析记录,将MHD患者分成无透中低血压组( N-IDH)和透析中低血压组( IDH)。收集患者同期实验室检查结果,并采集患者血清样本,检测血清FGF23与sKl水平。比较N-IDH与IDH患者之间生化指标差异。结果：共收集临床信息完整及血清标本完整患者80例,其中IDH发生率为77.5%,独立样本t检验分析结果提示五个指标在N-IDH和IDH组之间差异存在统计学意义,血铁蛋白(P=0.046)、血三酰甘油(P=0.045)、血iPTH (P=0.047)、钙磷乘积(P=0.042)和血清FGF23(P<0.001)。而sKl在两组间差异无统计学意义(P=0.747)。相关性检验提示IDH组的患者IDH发生频率与血清FGF23浓度的相关关系分析显示两者呈正相关(r=0.722,P<0.001)。结论：本组病例提示血清FGF23的水平与MHD患者透析中低血压的发生密切相关。
목적：탐토유지성혈액투석( maintenance hemodialysis,MHD)환자발생투중저혈압( intradialytic hypotension, IDH)여혈청중가용성klotho(soluble klotho,sKl)화성섬유세포생장인자23(fibroblast growth factor23,FGF23)지간적관계。방법：횡단면수집MHD환자병정자료,근거최근1개월내투석기록,장MHD환자분성무투중저혈압조( N-IDH)화투석중저혈압조( IDH)。수집환자동기실험실검사결과,병채집환자혈청양본,검측혈청FGF23여sKl수평。비교N-IDH여IDH환자지간생화지표차이。결과：공수집림상신식완정급혈청표본완정환자80례,기중IDH발생솔위77.5%,독립양본t검험분석결과제시오개지표재N-IDH화IDH조지간차이존재통계학의의,혈철단백(P=0.046)、혈삼선감유(P=0.045)、혈iPTH (P=0.047)、개린승적(P=0.042)화혈청FGF23(P<0.001)。이sKl재량조간차이무통계학의의(P=0.747)。상관성검험제시IDH조적환자IDH발생빈솔여혈청FGF23농도적상관관계분석현시량자정정상관(r=0.722,P<0.001)。결론：본조병례제시혈청FGF23적수평여MHD환자투석중저혈압적발생밀절상관。
Objective:To explore the relationship between intradialytic hypotension ( IDH) and serum fibroblast growth fac-tor23(FGF23) and serum soluble klotho(sKl) among maintenance hemodialysis (MHD) patients. Methods:We collected the cross-sectional data from MHD patients. Intradialytic blood pressure was recorded in a one-month period. According to patients’ dialysis records,the MHD patients were divided into the group of non intradialytic hypotension ( N-IDH) and the group of intradialytic hypo-tension (IDH). We collected the MHD patients’ results of laboratory examination and serum during Dec. 2013. The level of pa-tients’ serum FGF23 and serum sKl were detected. Results:Were analyzed with statistics,to contrast that their biochemical indicators have or not statistic difference between the two groups. Results:A total of 80 MHD patients in our dialysis center were enrolled into the study. The incidence rate of IDH was 77. 5%. Independent-samples t test showed that serum ferritin (P=0. 046),serum tri-glyceride (P=0. 045),parathyroid hormone (P =0. 042),calcium -phosphorus product (P =0. 047) and serum FGF23 (P <0. 001) have statistic difference between the two groups. But we could not be sure that sKl (P=0. 747) haven’t statistic difference between the two groups. Serum FGF23 was positively correlated with rate of IDH (r=0. 722,P<0. 001). Conclusion:Present study indicated that serum FGF23 was associated with IDH among MHD patients.