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目的:探讨慢性心力衰竭(CHF)患者血清成纤维细胞生长因子23(FGF23)浓度变化及其与心室重构参数的关系。方法:选取我院CHF患者209例(其中NYHAⅢ级组105例,NYHAⅣ级组104例)。酶联免疫吸附法(ELISA法)检测FGF23的浓度,超声心动图测定心脏结构参数并计算左心质量指数(LVMI)。分析FGF23浓度与心脏功能、心脏重构的相关性。结果:NYHAⅣ级组血红蛋白、尿酸、NT-proBNP、HDL、LDL、Na+、左室射血分数(LVEF)、LVMI与Ⅲ组有明显差别(P<0.05);NYHAⅣ级组血清FGF23浓度(855.28±338.94)ng/L显著高于Ⅲ级组(742.29±213.45)ng/L,P<0.05;血清FGF23浓度与LVMI、左室舒张末期内径(LVDd)、室间隔厚度(IVSd)、左室后壁厚度(PWT)呈正相关,r(LVMI)=0.237,r(LVDd)=0.163,r(IVSd)=0.241,r(PWT)=0.194,P<0.05,与LVEF呈负相关(r=-0.171,P<0.05)。结论:CHF患者NYHAⅣ级组血清中FGF23浓度较Ⅲ级组明显升高,FGF23浓度与CHF心室重构程度呈正相关。
Objective: To investigate the changes of serum fibroblast growth factor 23 (FGF23) concentration in patients with chronic heart failure (CHF) and its relationship with parameters of ventricular remodeling. Methods: 209 patients with CHF in our hospital (including NYHA Ⅲ grade 105 cases, NYHA Ⅳ 104 cases). The concentration of FGF23 was detected by enzyme-linked immunosorbent assay (ELISA), cardiac structural parameters were measured by echocardiography and left ventricular mass index (LVMI) was calculated. The correlation between FGF23 concentration and cardiac function and cardiac remodeling was analyzed. Results: The levels of hemoglobin, uric acid, NT-proBNP, HDL, LDL, Na +, LVEF and LVMI in group NYHA Ⅳ were significantly different from those in group Ⅲ (P <0.05) The levels of serum FGF23 and LVMI, LVDd, IVSd, left ventricular posterior wall PWV was 0.237, r (LVDd) = 0.163, r (IVSd) = 0.241, r (PWT) = 0.194, P <0.05 and negatively correlated with LVEF (r = -0.171, P <0.05). CONCLUSION: The serum FGF23 concentration in NYHA Ⅳ group of patients with CHF is significantly higher than that in the third grade group, and the concentration of FGF23 is positively correlated with the degree of ventricular remodeling in CHF.