河北医科大学学报 ›› 2021, Vol. 42 ›› Issue (5): 531-535.doi: 10.3969/j.issn.1007-3205.2021.05.008

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β-CTX、UA、FGF-23与慢性肾衰竭透析患者矿物质-骨异常的关系

  

  1. 1.海军军医大学附属长征医院肾脏科, 上海  200003；2.上海交通大学医学院附属
    第九人民医院黄浦分院肾内科,上海  200011
  • 出版日期:2021-05-25 发布日期:2021-05-28
  • 作者简介:陶晓阳（1979-），男，江苏无锡人，海军军医大学附属长征医院副主任医师，医学学士，从事急性肾损伤、梗阻性肾病疾病诊治研究。
  • 基金资助:
    国家自然科学基金（81770659）；上海市重中之重临床重点学科(2017ZZ02009)；上海市临床重点专科（shslczdzk02503）

Relationship between β-CTX, UA, FGF-23 and mineral bone abnormality in patients with chronic renal failure undergoing hemodialysis

  1. 1.Department of Nephrology, Changzheng Hospital Affiliated to Naval Medical University, Shanghai
    200003, China; 2.Department of Nephrology, Huangpu Branch of the Ninth People′s Hospital Affiliated
    to Medical College of Shanghai Jiaotong University, Shanghai 200011, China
  • Online:2021-05-25 Published:2021-05-28

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摘要： 目的  研究Ⅰ型胶原羧基端肽β特殊序列（type I collagen carboxy terminal peptide β special sequence，β-CTX）、尿酸（uric acid，UA）、成纤维细胞生长因子23（fibroblast growth factor-23，FGF-23）与慢性肾衰竭透析患者矿物质-骨异常的关系。
方法   纳入我院收治的80例慢性肾衰竭透析患者为研究对象，开展回顾性分析。统计患者一般资料，包括年龄、体重指数、原发病、磷结合剂使用情况、透析龄及β-CTX、UA、FGF-23等实验室指标，调查患者矿物质-骨异常发生情况，并采用多因素Logistic回归分析慢性肾衰竭透析患者矿物质-骨异常的独立影响因素，分析β-CTX、UA、FGF-23与慢性肾衰竭透析患者矿物质-骨异常的关系。
结果  80例慢性肾衰竭透析患者中存在矿物质-骨异常44例，设为矿物质-骨异常组，非矿物质-骨异常36例，设为非矿物质-骨异常组。矿物质-骨异常组年龄、透析龄、血清白蛋白（serum albumin，SA）、UA、FGF-23均显著高于非矿物质-骨异常组（P＜0.05），β-CTX显著低于非矿物质-骨异常组（P＜0.05）。多因素Logistic回归分析显示，年龄（OR=1.364，P=0.034）、透析龄（OR=1.534，P＜0.001）、UA（OR=1.502，P=0.165）、β-CTX（OR=1.486，P＜0.001）、FGF-23（OR=1.385，P=0.001）是慢性肾衰竭透析患者矿物质-骨异常的独立影响因素（P＜0.05）。
结论  年龄、透析龄、UA、β-CTX、FGF-23是慢性肾衰竭透析患者矿物质-骨异常的独立影响因素，临床应引起重视。

关键词: 肾功能不全, 透析, 尿酸

Abstract: Objective  To investigate the relationship between type I collagen carboxy terminal peptide β special sequence(β-CTX), uric acid(UA), fibroblast growth factor 23(FGF-23) and mineral bone abnormalities in patients with chronic renal failure(CRF) undergoing hemodialysis.
Methods  A total of 80 patients with CRF undergoing hemodialysis in our hospital were included in the study, and the retrospective analysis was carried out. The general data of the patients were collected, including age, body mass index, primary disease, usage of phosphate bond, dialysis duration and laboratory indexes such as β-CTX, UA, FGF-23, etc., and the incidence of mineral bone abnormality was investigated. Multivariate Logistic regression analysis was used to analyze the independent influencing factors of mineral bone abnormality in CRF patients undergoing hemodialysis, and the relationship between β-CTX, UA, FGF-23 and mineral bone abnormality in CRF patients undergoing hemodialysis was analyzed.
Results  Among 80 patients with CRF undergoing hemodialysis, there were 44 cases with mineral bone abnormality, which were set as mineral bone abnormality group, and 36 cases with non-mineral bone abnormality, which were set as non-mineral bone abnormality group. The age, dialysis duration, serum albumin(SA), UA, FGF-23 in the mineral bone abnormality group were significantly higher than those in the non-mineral bone abnormality group（P＜0.05）, and the β-CTX was significantly lower than that in the non-mineral bone abnormality group（P＜0.05）. Multivariate Logistic regression analysis showed that age（OR=1.364，P=0.034）, dialysis duration （OR=1.534，P＜0.001）, UA（OR=1.502，P=0.165）, β-CTX（OR=1.486，P＜0.001）and FGF-23（OR=1.385，P=0.001） were the independent influencing factors of mineral bone abnormality in CRF patients undergoing hemodialysis（P＜0.05）. 
Conclusion  Age, dialysis duration, UA, β-CTX and FGF-23 are independent influencing factors of mineral bone abnormalities in patients with CRF undergoing hemodialysis, and special attention should be paid to this in clinical practice.

Key words: renal insufficiency, hemodialysis, uric acid

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