CAJ | 학술논문

目的：探讨成纤维细胞生长因子23（ FGF-23）与血液透析患者心血管疾病的关系。方法选择维持性血液透析患者共70例为研究组，匹配21例体检者为对照组。研究组又分为心血管病变组（ n=24）与非心血管病变组（n=46）。所有研究对象检测采血检测血红蛋白（Hb）、白蛋白（ALB）、肌酐（Cr）、尿素氮（BUN）、尿酸（UA）、钙（Ca）、磷（P）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL -C）、空腹血糖（ FPG）、血清全段甲状旁腺激素（ iPTH）、FGF-23水平。研究组对象检测C-反应蛋白（ CRP）、胱抑素C（ CysC）和血浆N末端B型钠尿肽前体（ NT-pro BNP）水平。采用彩色多普勒超声仪对研究组患者进行心脏超声检查，计算射血分数（LVEF）和左心室质量指数（LVMI），并比较分析。结果研究组血清Hb、ALB、Ca水平低于对照组，Cr、BUN、UA、P、iPTH、FGF-23水平高于对照组，差异均有显著性（ P <0.05），两组TG、TC、HDL-C、LDL-C、FPG水平无显著差异（ P>0.05）。心血管病变组FGF-23、CysC、NT-pro BNP、LVMI显著高于非心血管病变组，LVEF显著低于非心血管病变组。对血液透析患者心血管疾病发生的各种检测指标的逐步Logistic回归分析发现，只有FGF-23、NT-pro BNP和Cy-sC进入回归方程，OR分别为3.024、2.783、2.454。结论 FGF-23与维持性血液透析患者心血管病变有着密切的联系，其在预测心血管疾病发生中的价值略优于NT-pro BNP和CysC，对观察维持性血液透析患者心血管病的发生、发展具有重要的意义。
목적：탐토성섬유세포생장인자23（ FGF-23）여혈액투석환자심혈관질병적관계。방법선택유지성혈액투석환자공70례위연구조，필배21례체검자위대조조。연구조우분위심혈관병변조（ n=24）여비심혈관병변조（n=46）。소유연구대상검측채혈검측혈홍단백（Hb）、백단백（ALB）、기항（Cr）、뇨소담（BUN）、뇨산（UA）、개（Ca）、린（P）、감유삼지（TG）、총담고순（TC）、고밀도지단백담고순（HDL-C）、저밀도지단백담고순（LDL -C）、공복혈당（ FPG）、혈청전단갑상방선격소（ iPTH）、FGF-23수평。연구조대상검측C-반응단백（ CRP）、광억소C（ CysC）화혈장N말단B형납뇨태전체（ NT-pro BNP）수평。채용채색다보륵초성의대연구조환자진행심장초성검사，계산사혈분수（LVEF）화좌심실질량지수（LVMI），병비교분석。결과연구조혈청Hb、ALB、Ca수평저우대조조，Cr、BUN、UA、P、iPTH、FGF-23수평고우대조조，차이균유현저성（ P <0.05），량조TG、TC、HDL-C、LDL-C、FPG수평무현저차이（ P>0.05）。심혈관병변조FGF-23、CysC、NT-pro BNP、LVMI현저고우비심혈관병변조，LVEF현저저우비심혈관병변조。대혈액투석환자심혈관질병발생적각충검측지표적축보Logistic회귀분석발현，지유FGF-23、NT-pro BNP화Cy-sC진입회귀방정，OR분별위3.024、2.783、2.454。결론 FGF-23여유지성혈액투석환자심혈관병변유착밀절적련계，기재예측심혈관질병발생중적개치략우우NT-pro BNP화CysC，대관찰유지성혈액투석환자심혈관병적발생、발전구유중요적의의。
Objective To investigate the relationship between fibroblast growth factor-23(FGF-23)and cardiovascular disease in he-modialysis patients. Methods Seventy cases of maintenance hemodialysis were collected for the study group,and 21 volunteers were matched for the control group. The study group was divided into cardiovascular disease group(n = 24)and non-cardiovascular disease group(n = 46). Serum levels of blood hemoglobin( Hb),albumin( ALB),creatinine( Cr),blood urea nitrogen( BUN),uric acid( UA),calcium( Ca),phos-phorus(P),triglycerides(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL -C),low density lipoprotein cholesterol (LDL-C),fasting plasma glucose(FPG),iPTH and FGF-23 were detected in all of the subjects. Detection of C-reactive protein(CRP), cystatin C( CysC)and plasma N-terminal B-type natriuretic peptide precursor( NT-pro BNP)levels were taken in the study group. Color Doppler ultrasound was used in study group to calculate left ventricular ejection fraction( LVEF)and left ventricular mass index( LVMI),and comparative analysis was undertaken. Results Serum levels of Hb,ALB and Ca in the study group were significantly lower than the control group;Cr,BUN,UA,P,iPTH,and FGF-23 were significantly higher than the control group(all P <0. 05). TG,TC,HDL-C,LDL-C, FPG had no significant differences in two groups(all P >0. 05). FGF-23,CysC,NT-pro BNP and LVMI in cardiovascular disease group was significantly higher than non-cardiovascular disease group,and LVEF was significantly lower than non-cardiovascular disease group. On a varie-ty of indicators to detect cardiovascular disease in hemodialysis patients,stepwise logistic regression analysis showed that only FGF-23,NT-pro BNP and CysC entered the regression equation,with OR 3. 024,2. 783 and 2. 454,respectively. Conclusion FGF-23 is closely linked to car-diovascular disease in patients with maintenance hemodialysis,which is slightly better than NT-pro BNP and CysC in predicting the occurrence of cardiovascular disease and has important significance for the observation of occurrence and development of cardiovascular disease in hemodialysis patients.