【摘要】 目的观察血浆FGF-23水平对慢性肾脏病(CKD)患者血压的影响。方法选择经实验室、影像学等检查确诊为CKD的患者140例作为CKD组,CKD患者按照肾小球滤过率分为1~5期;选择同期就诊于体检中心且性别、年龄、体质量指数相当的健康体检者140例作为健康组。比较2组血压、肾小球滤过率、血尿酸、血浆FGF-23水平的差异及不同CKD分期患者间年龄、体质量指数、血压、肾小球滤过率、血尿酸、血浆FGF-23、血钙、血磷、甲状旁腺激素水平的差异,使用Spearman相关分析分析CKD组患者血浆FGF-23水平与其他相关指标的关系。结果 CKD组收缩压、舒张压、平均动脉压、血尿酸、血浆FGF-23水平均显著高于健康组(P均<0.05),肾小球滤过率明显低于健康组(P<0.05)。不同CKD分期患者间收缩压、平均动脉压、血磷水平随临床分期的增高逐渐增高,血钙水平随临床分期的增高略有下降,但差异均无统计学意义(P均>0.05);CKD 2~5期患者血尿酸水平均明显高于CKD1期患者(P均<0.05),但CKD5期患者血尿酸水平明显低于CKD4期患者(P<0.05);甲状旁腺激素水平随CKD分期增高逐渐增高,其中CKD2期与CKD3期比较及CKD3期与CKD4期比较差异均有统计学意义(P均<0.05);FGF-23水平随肾小球滤过率的升高逐渐升高,且各分期之间比较差异均有统计学意义(P均<0.05)。CKD患者血浆FGF-23水平与收缩压呈正相关(r=0.27,P<0.05),与肾小球滤过率呈负相关(r=-0.91,P<0.05),与舒张压及平均动脉压无相关性。结论血浆FGF-23水平与CKD患者收缩压和肾小球滤过率密切相关,控制FGF-23水平可能会成为治疗CKD高血压的新靶点。更多还原

【Abstract】 Objective It is to observe the effect of plasma FGF-23 on blood pressure in patients with chronic kidney disease(CKD).Methods 140 patients with CKD were enrolled were divided into 5 groups according to the CKD staging.During the same period,140 sex and age matched healthy adults were enrolled as health control.The differences in BP,GFR,UA,plasma FGF-23 between CKD group and control group and the difference in age,BMI,BP,GFR,UA,blood FGF-23,Ca,P and parathyroid hormone among different CKD staging were compared.Spearman correlation analysis was used to analyze the correlationship of FGF-23 with the other indexes.Results The levels of plasma FGF-23,SBP,DBP,MAP,UA in CKD group were higher while GFR was lower than that in healthy group(P<0.05).In CKD patients,the levels of SBP,MAP,serum P and parathyroid hormone increased while serum Ca decreased with staging increasing,the levels of FGF-23 increased with GFR increasing.Spearman correlation analysis showed that the plasma FGF-23 expression level was positively correlated with SBP(r=0.27,P<0.05),negative correlated with GFR(r=-0.91,P<0.05),not correlated with DBP and MAP.Conclusion Plasma FGF-23 is closely correlated with SBP and GFR in CKD patients,controlling FGF-23 may be new target point for the treatment of CKD with hypertension.更多还原