血清OPG BSAP及FGF-23对血液透析患者血管钙化的诊断价值

doi:10.3969/j.issn.1006-6233.2021.08.025

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摘要 目的: 探讨血清骨保护素(OPG)、骨特异性碱性磷酸酶(BSAP)及成纤维细胞生长因子23(FGF-23)对血液透析患者血管钙化(VC)的诊断价值。方法: 选取2018年1月至2020年10月血液透析患者133例,其中VC患者58例为钙化组,未发生VC患者75例为未钙化组。采用酶联免疫吸附法(ELISA)检测血清OPG、BSAP及FGF-23水平,绘制ROC曲线探讨血清OPG、BSAP及FGF-23对VC的诊断价值。结果: 钙化组患者血清OPG、BSAP及FGF-23水平高于未钙化组(P<0.05);随着钙化程度的加重,血清OPG、BSAP及FGF-23水平呈明显升高趋势(P<0.05)。Spearman相关性分析显示,血清OPG、BSAP及FGF-23水平与透析患者VC评分呈显著正相关(P<0.05);Logistic回归分析发现,透析龄长及血清OPG、BSAP、FGF-23水平升高是透析患者发生VC的危险因素(P<0.05)。血清OPG、BSAP、FGF-23单项检测诊断VC的曲线下面积(AUC)为0.853、0.864、0.866。联合检测诊断VC的AUC及特异度较单项检测均显著升高(P<0.05)。结论: 血清OPG、BSAP及FGF-23的表达与血液透析患者VC密切相关,联合检测三项指标对VC的诊断和病情评估具有重要意义。

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	宋菊香
	夏薇青
	王天智
	刘翠红

关键词 ：血管钙化, 血液透析, 骨保护素, 骨特异性碱性磷酸酶, 成纤维细胞生长因子23

Abstract：Objective: To investigate the diagnostic value of serum Osteoprotegerin (OPG), bone specific alkaline phosphatase (BSAP) and fibroblast growth factor 23 (FGF-23) for vascular calcification (VC) in patients under hemodialysis. Methods: A total of 133 patients under hemodialysis were selected from January 2018 to October 2020, of which 58 patients with VC were in the calcification group and 75 patients without VC were in the non-calcification group. The levels of serum OPG, BSAP and FGF-23 in the two groups were determined by enzyme linked immunosorbent assay (ELISA). The diagnostic values of serum OPG, BSAP and FGF-23 in VC were explored by ROC curve. Results: The levels of serum OPG, BSAP and FGF-23 in the calcification group were higher than those in the non-calcification group (P<0.05). With the aggravation of calcification, the levels of serum OPG, BSAP and FGF-23 were significantly increased (P<0.05). Spearman correlation analysis showed that OPG, BSAP and FGF-23 were positively correlated with VC score of dialysis patients (P<0.05). Logistic regression analysis showed that longer dialysis age and elevated of OPG, BSAP, FGF-23 were risk factors for VC in dialysis patients (P<0.05). The AUC of serum OPG, BSAP and FGF-23 were 0.853, 0.864 and 0.866 respectively. The AUC and specificity of the combined test in VC were significantly higher than that of the single test (P<0.05). Conclusion: The expression of serum OPG, BSAP and FGF-23 is closely related to VC in patients under hemodialysis. The combined detection is of great significance for the diagnosis and evaluation of VC.

Key words： Vascular calcification Hemodialysis Osteoprotegerin Bone specific alkaline phosphatase Fibroblast growth factor 23

基金资助:2020年河北省医学科学研究重点课题计划,(编号:20200146)

引用本文:

宋菊香, 夏薇青, 王天智, 刘翠红. 血清OPG BSAP及FGF-23对血液透析患者血管钙化的诊断价值[J]. 河北医学, 2021, 27(8): 1348-1352.
SONG Juxiang, XIA Weiqing, WANG Tianzhi, et al. The Diagnostic Value of Serum OPG BSAP and FGF-23 for Vascular Calcification in Patients Under Hemodialysis. HeBei Med, 2021, 27(8): 1348-1352.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2021.08.025 或 http://www.hbyxzzs.cn/CN/Y2021/V27/I8/1348

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