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目的探讨Klotho蛋白及成纤维细胞生长因子(FGF)-23在慢性肾脏病(CKD)发生、发展中的作用。方法选取2014年3月至2016年3月该院收治的160例CKD患者纳入CKD组,同时将160例健康体检者纳入对照组,对2组研究对象基本临床资料、血生化指标、血清Klotho蛋白及FGF-23水平进行对比分析。结果CKD组患者血红蛋白(Hb)、血清清蛋白(ALB)、血钙(Ca)、肾小球滤过率(GFR)、Klotho蛋白水平均低于对照组,血肌酐(Cr)、血清尿素(Urea)、血磷(P)、FGF-23水平均高于对照组(P<0.05)。随着CKD患者分期的进展,Hb、GFR、Klotho蛋白水平逐渐降低,Cr、Urea、P、FGF-23水平逐渐升高(P<0.05)。相关性分析发现,CKD患者血清FGF-23水平与Hb、GFR、Klotho蛋白水平呈负相关(r=-0.584、0.692、-0.724),与Cr、P、Urea呈正相关(r=0.814、0.703、0.527);血清Klotho蛋白水平与Hb、GFR水平呈正相关(r=0.612、0.685),与Cr、P、Urea、FGF-23呈负相关(r=-0.720、-0.690、-0.519、0.724)。结论高水平FGF-23及低水平Klotho蛋白不仅与CKD患者钙磷代谢紊乱有关,也与CKD患者的预后有关,可能成为CKD患者的早期生物标志物及病情的预测指标。
Objective To investigate the role of Klotho protein and fibroblast growth factor (FGF) -23 in the development of chronic kidney disease (CKD). Methods A total of 160 patients with CKD admitted to our hospital from March 2014 to March 2016 were enrolled in the CKD group and 160 healthy subjects were included in the control group. The basic clinical data, blood biochemical indexes, serum Klotho protein And FGF-23 levels for comparative analysis. Results The serum levels of Hb, ALB, GFR and Klotho in CKD group were lower than those in control group, serum creatinine (Cr) and serum urea Urea, P and FGF-23 levels were higher than those of the control group (P <0.05). With the progress of CKD, the levels of Hb, GFR and Klotho gradually decreased, and the levels of Cr, Urea, P and FGF-23 gradually increased (P <0.05). Correlation analysis showed that serum FGF-23 level was negatively correlated with Hb, GFR and Klotho protein levels (r = -0.584,0.692, -0.724), positively correlated with Cr, P and Urea (r = 0.814,0.703, 0.527). Serum Klotho protein levels were positively correlated with Hb and GFR (r = 0.612,0.685), but negatively correlated with Cr, P, Urea and FGF-23 (r = -0.720,0.690,0.519,0.724). Conclusions The high level of FGF-23 and low level of Klotho protein are not only related to disorder of calcium and phosphorus metabolism in patients with CKD, but also to the prognosis of patients with CKD, which may be the early biomarkers and predictors of CKD.