摘要
目的 探讨持续非卧床腹膜透析(CAPD)患者血清FGF-23及可溶性klotho蛋白与颈动脉内膜-中膜厚度(CIMT)的相关性.方法 选择2021年1月至2023年4月CAPD患者60例.将CIMT≥1.2 mm的患者纳入观察组(n=36),CIMT<1.2 mm的患者纳入对照组(n=24),比较两组患者一般资料及颈动脉彩超检查结果;分别测定并比较两组患者胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、血清肌酐、超敏C反应蛋白(Hs-CRP)、β2-微球蛋白、甲状旁腺激素、同型半胱氨酸、可溶性Klotho蛋白、血清FGF-23等指标.结果 观察组患者年龄、血清FGF-23及Hs-CRP水平均明显高于对照组,差异有统计学意义(P<0.05);观察组患者血清可溶性Klotho蛋白水平明显低于对照组,差异有统计学意义(P<0.05);观察组CIMT水平、存在粥样硬化斑块比例均明显高于对照组(P<0.05);两组间颈动脉狭窄比例比较,差异无统计学意义(P>0.05);Logistic回归分析结果显示,年龄、血清FGF-23及Hs-CRP是CAPD患者发生CIMT增厚的独立的危险因素,而可溶性Klotho蛋白是CAPD患者出现CIMT增厚的保护因素.结论 CAPD伴有CIMT增厚的患者易形成动脉粥样硬化斑块,患者年龄、血清FGF23、超敏C反应蛋白是CAPD患者颈动脉中膜增厚的独立危险因素,而Klotho蛋白则为其保护因素.
Abstract
Objective To investigate the relationship between serum FGF-23,soluble klotho protein and carotid intima-media thickness(CIMT)in patients undergoing continuous ambulatory peritoneal dialysis(CAPD).Methods From January 2021 to April 2023,60 patients treated with CAPD in the peritoneal dialysis center of our hospital were selected as the research object.Patients with CIMT≥1.2 mm were included in the thickening group(n=36),and patients with CIMT<1.2 mm were included in the normal group(n=24).General information and carotid ultrasound examination in both groups were compared.Cholesterol,triglyceride,high-density lipoprotein,low-density lipoprotein,scr,high-sensitivity C-reactive protein(Hs-CRP),β2-Microglobulin,parathyroid hormone,homocysteine,soluble Klotho protein,serum FGF-23 and other indicators were determination respectively.Results The age,serum FGF-23,and Hs-CRP in the CIMT thickening group compared the normal group were significantly higher(P<0.05).In the CIMT thickening group,the serum soluble Klotho protein compared the CIMT normal group were significantly lower(P<0.05).In CIMT thickening group,the CIMT level and the atherosclerotic plaque proportion compared the CIMT normal group were significantly higher(P<0.05).In both groups,the proportion of carotid artery stenosis was of no statistically significant difference(P>0.05).The logistic regression analysis showed that age,serum FGF-23,and Hs-CRP were independent risk factors for CIMT thickening in CAPD patients,while soluble Klotho protein was a protective factor for CIMT thickening in CAPD patients.Conclusion CAPD patients with CIMT thickening are prone to form atherosclerotic plaque.Age,serum FGF23 and high-sensitivity C-reactive protein can be considered as independent risk factors of carotid artery middle membrane thickening in CAPD patients,while Klotho protein is a protective factor.
维普
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