| 樊 星,毕朝煜,高 燕,张海松,李 哲.维持性腹膜透析患者血管钙化评估及血清sclerostin、FGF-23测定对血管钙化发生风险的预测价值研究[J].,2022,(7):1380-1384 |
| 维持性腹膜透析患者血管钙化评估及血清sclerostin、FGF-23测定对血管钙化发生风险的预测价值研究 |
| Evaluation of Vascular Calcification and Predictive Value Study of Serum Sclerostin and FGF-23 in Patients with Maintenance Peritoneal Dialysis |
| 投稿时间：2021-10-23 修订日期：2021-11-18 |
| DOI：10.13241/j.cnki.pmb.2022.07.039 |
| 中文关键词: 血管钙化 维持性腹膜透析 Sclerostin FGF-23 预测价值 |
| 英文关键词: Vascular calcification Maintenance peritoneal dialysis Sclerostin FGF-23 Predictive value |
| 基金项目:河北省自然科学基金项目（H2018201289） |
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| 中文摘要: |
| 摘要 目的：评估维持性腹膜透析（PD）患者血管钙化（VC）情况，分析血清骨硬化蛋白（sclerostin）、成纤维生长因子-23（FGF-23）测定对VC发生风险的预测价值。方法：选择2018年5月~2021年6月期间我院收治的维持性PD患者103例为研究对象。收集所有患者的临床资料进行分析，观察VC情况，多因素Logistic回归分析维持性PD患者VC的危险因素。受试者工作特征曲线（ROC）分析血清sclerostin、FGF-23单独及联合测定对VC的预测价值。结果：103例维持性PD患者中有69例（66.99%）存在不同部位、不同程度的VC。根据是否出现VC进行分组，其中VC患者69例（VC组），未出现VC患者34例（无VC组）。与无VC组患者相比，VC组年龄、合并糖尿病人数占比、血清sclerostin、FGF-23、血钙（Ca）水平明显更高，透析时间明显更长，全段甲状旁腺激素水平明显更低（P<0.05）。透析时间≥32月、年龄≥55岁、合并糖尿病、血清FGF-23≥80 pg/mL、Ca≥1.3 mmol/L、血清sclerostin≥7 ng/mL是维持性PD患者并发VC的危险因素（P＜0.05）。血清sclerostin、FGF-23的曲线下面积（AUC）（0.95CI）分别为0.783（0.691～0.858）、0.793（0.702～0.866），有一定的预测效能，而两指标联合应用时：AUC（0.95CI）为0.867（0.786～0.926），预测效能更高。结论：维持性PD患者VC的发生与透析时间、年龄、合并糖尿病、FGF-23、Ca、sclerostin有关，sclerostin、FGF-23联合测定对VC发生风险的预测价值较高，对于此类患者VC的评估具有辅助作用。 |
| 英文摘要: |
| ABSTRACT Objective: To evaluate vascular calcification (VC) situation in patients with maintenance peritoneal dialysis (PD), and to analyze the predictive value of serum sclerostin (sclerostin) and fibroblast growth factor-23 (FGF-23) in the VC occurrence risk. Methods: 103 patients with maintenance PD who were treated in our hospital from May 2018 to June 2021 were selected as the research objects. The clinical data of all patients were collected for analysis, the VC situation was observed, and the risk factors of VC in patients with maintenance PD were analyzed by multivariate Logistic regression. The predictive value of serum sclerostin, FGF-23 alone and combination determination on VC was analyzed by receiver operating characteristic curve (ROC). Results: 69 cases (66.99%) of 103 patients with maintenance PD had VC in different parts and degrees. According to whether there was VC or not, there were 69 cases of patients with VC (VC group) and 34 cases of patients without VC (no VC group). Compared with patients in no VC group, the age, proportion of complicated with diabetes mellitus, serum sclerostin, FGF-23, blood calcium (Ca) levels significantly higher in VC group, dialysis time significantly longer, and total parathyroid hormone level significantly lower (P<0.05). dialysis time≥32 months, age≥55 years, complicated with diabetes mellitus, serum FGF-23≥80 pg/mL, Ca≥1.3 mmol/L, serum sclerostin≥7 ng/mL were risk factors for VC occurrence in patients with maintenance PD (P<0.05). The area under curve (AUC) (0.95CI) of serum screrostin and FGF-23 were 0.783 (0.691~0.858) and 0.793 (0.702~0.866) respectively, which had a certain prediction efficiency. When the indexes were combined, the AUC (0.95CI) was 0.867 (0.786~0.926), which had a higher prediction efficiency. Conclusion: The VC occurrence in patients with maintenance PD is related to dialysis time, age, complicated with diabetes mellitus, FGF-23, Ca and sclerostin. The combination determination of sclerostin and FGF-23 has a high predictive value for the VC occurrence risk, and plays an auxiliary role in the evaluation of VC in such patients. |
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