| 陈东,蒋知新,张洁,等.血清骨硬化蛋白、成纤维细胞因子 -23、可溶性 CD40配体联合检测对维持性血液透析并发心血管事件的预测价值[J].安徽医药,2023,27(2):291-296. |
| 血清骨硬化蛋白、成纤维细胞因子 -23、可溶性 CD40配体联合检测对维持性血液透析并发心血管事件的预测价值 |
| Predictive value of combined serum SOST, FGF-23 and sCD40L for cardiovascular events complicated by maintenance hemodialysis |
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| DOI：10.3969/j.issn.1009-6469.2023.02.018 |
| 中文关键词: 肾透析 /并发症 骨硬化蛋白 成纤维细胞因子 -23 可溶性 CD40配体 心血管事件 |
| 英文关键词: Renal dialysis/complications Sclerostin Fibroblast growth factor-23 Soluble CD40 ligand Cardiovascular events |
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| 摘要点击次数: 813 |
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| 中文摘要: |
| 目的探讨血清骨硬化蛋白( SOST)、成纤维细胞因子 -23(FGF-23)、可溶性 CD40配体( sCD40L)联合检测对维持性血液透析( MHD)病人并发心血管事件的预测价值。方法选取 2017年 1月至 2019年 3月中国人民解放军第 305医院收治的行 MHD的 149例病人作为研究对象，根据 MHD病人有无心血管事件发生将其分为未发生组和发生组，另选取同期 128例健康体检者设为对照组。比较各组 SOST、FGF-23、sCD40L，找出影响 MHD病人并发心血管事件的危险因素。结果 MHD病人心血管事件发生率为 33.56%，发生组年龄( 59.11±10.74)岁、血肌酐( Scr)(849.07±156.81)μmol/L及血清 SOST(119.83±22.78)pmol/ L、FGF-23(569.07±92.84)ng/L、sCD40L(119.49±23.86)μg/L水平均高于未发生组和对照组，均差异有统计学意义( P<0.05)发生组 Scr(753.73±112.06)mol/L及血清 SOST(86.23±16.05)pmol/L、FGF-23(439.14±78.02)ng/L、sCD40L(82.02±15.53)μg/L水未，平均高于对照组，均差异有统计学意义( P<0.05)； MHD病人血清 SOST水平与钙( Ca)呈正相关(P<0.05)血清 FGF-23水平与磷(P)呈正相关( P<0.05)；年龄大、收缩压高、透析时间长、高水平的尿酸( UA)、血肌酐( Scr)、胱抑素 C(Cys-，C)、超敏 C反应蛋白(hs-CRP)、三酰甘油( TG)与高水平的 SOST、FGF-23、sCD40L均为是影响 MHD病人并发心血管事件的危险因素( P<0.05)；血清 SOST、FGF-23、sCD40L水平联合预测 MHD病人并发心血管事件的灵敏度和曲线下面积( AUC)分别为 98.00%和 0.96，均高于单一指标评价( P<0.01)。结论血清 SOST、FGF-23、sCD40L水平升高均是 MHD病人并发心血管事件的危险因素，以上三项 |
| 英文摘要: |
| Objective To explore the predictive value of the combination of serum sclerostin (SOST) protein, fibroblast growth fac-tor-23 (FGF-23) and soluble CD40 ligand (sCD40L) on cardiovascular events in maintenance hemodialysis (MHD) patients.Methods A total of 149 MHD patients admitted to the 305 Hospital of the Chinese People's Liberation Army (PLA) in January 2017 to March2019 were selected for the study. The patients were divided into a nonoccurrence group and an occurrence group according to the pres-ence or absence of cardiovascular events, and 128 healthy patients were selected as the control group during the same period. SOST,FGF-23 and sCD40L were compared among the groups to determine the risk factors affecting the complications of cardiovascular eventsin MHD patients.Results The incidence of cardiovascular events in MHD patients was 33.56%, and the age (59.11±10.74) years, se-rum creatinine (Scr) (849.07±156.81) μmol/L and serum SOST (119.83±22.78)pmol/L, FGF-23 (569.07±92.84)ng/L, and sCD40L(119.49±23.86)μg/L levels were higher than those in the nonoccurrence group and the control group (P<0.05). The levels of Scr (753.73±112.06)μmol/L, SOST (86.23±16.05)pmol/L, FGF-23 (439.14±78.02)ng/L and sCD40L (82.02±15.53)μg/L in the nonoccur-rence group were higher than those in the control group (P<0.05). The serum SOST levels were positively correlated with calcium (Ca) and serum FGF-23 levels were positively correlated with phosphorus (P) in MHD patients (P<0.05). Older age, high systolic blood pres-sure, longer dialysis time, higher levels of uric acid (UA), Scr, cystatin C (Cys-C),hypersensitive C-reactive protein (hs-CRP), and tri-glycerides (TGs) and higher levels of SOST, FGF-23, and sCD40L were all risk factors for concurrent cardiovascular events in MHD pa-tients (P<0.05).The sensitivity and area under the curve (AUC) of combined serum SOST,FGF-23 and sCD40L levels in predicting con-current cardiovascular events in MHD patients were 98.00% and 0.96, respectively, which were higher than those evaluated by a singleindex (P<0.01).Conclusions The elevated levels of serum SOST, FGF-23 and sCD40L are all risk factors for concurrent cardiovascu-lar events in MHD patients.All three of these indicators have good predictive value for concurrent cardiovascular events in patients withMHD, but the value is higher when the three are combined. |
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