摘要
【目的】探究维持性血液透析(maintenance hemodialysis,MHD)患者血清生长分化因子-15(growth differentiation factor-15,GDF-15)表达、血磷与左心室肥厚(left ventricular hypertrophy,LVH)的相关性研究。【方法】选取2017年1月至2019年1月血液净化中心收治的135例MHD患者为研究对象,依据左心室质量指数(left ventricular mass indix,LVMI)将患者分为LVH组和非LVH组。检测受试者血清GDF-15水平,血钙、血磷水平,检测受试者心脏结构及功能,分析LVH患者LVMI水平与血清GDF-15、血磷的关系以及LVH发生的影响因素,评价血清GDF-15水平对LVH的预测价值。【结果】LVH组患者收缩压、血清GDF-15、血磷水平均高于非LVH组(P<0.05);LVH患者LVMI水平与血清GDF-15、血磷均呈正相关(P<0.05);GDF-15是影响LVH的危险因素(P<0.05);血清GDF-15水平预测LVH的曲线下面积(area under curve,AUC)为0.878,截断值为926.73 pg/mL,其灵敏度、特异度分别为87.8%、75.7%。【结论】MHD患者血清GDF-15、血磷均显著升高,其可能与LVMI相互影响,从而协同影响LVH发展,检测血清GDF-15水平有利于筛查LVH患者。
【Objective】To explore the correlation between serum growth differentiation factor-15(GDF-15)expression,serum phosphorus and left ventricular hypertrophy(LVH)in maintenance hemodialysis(MHD)patients.【Methods】A total of 135 MHD patients in the blood purification center of our hospital from January 2017 to January 2019 were selected as the study objects,and according to left ventricular mass index(LVMI),the patients were divided into LVH group(n=98)and non LVH group(n=37).The general data of the two groups were analyzed and compared.Enzyme linked immunosorbent assay(ELISA)was used to detect the serum GDF-15 level in all subjects.The levels of serum calcium and phosphorus were measured by automatic biochemical analyzer.The heart structure and function of all subjects were detected by color Doppler echocardiography,and LVMI was calculated.Pearson method was used to analyze the relationship between LVMI level and serum GDF-15,serumphosphorus.The influencing factors of LVH were analyzed by Logistic regression.In addition,the predictive value of serum GDF-15 level on LVH was evaluated by receiver operating characteristic curve(ROC).【Results】The levels of systolic blood pressure,serum GDF-15,serumphosphorusin the LVH group were significantly higher than those in the non LVH group(P<0.05),while there was no significant difference in age,male-to-female ratio,diastolic pressure,hemoglobin,fasting blood glucose and total cholesterol(P>0.05).There was a positive correlation between LVMI level and serum GDF-15,serum phosphorus(P<0.05).GDF-15 was the risk factor of LVH(P<0.05).In addition,the area under curve(AUC)of serum GDF-15 level was 0.878,the cutoff value was 926.73 pg/ml,and the sensitivity and specificity were 87.8%and 75.7%,respectively.【Conclusion】The levels of serum GDF-15 and serumphosphorus are increased significantly in MHD patients,which may interact with LVMI,thus affecting the development of LVH.Detection of serum GDF-15 level is helpful to screen LVH patients.
作者
姚娬斌
沈良兰
黄华星
沈燕
YAO Wu-bin;SHEN Liang-lan;HUANG Hua-xing;SHEN Yan(Department of Nephrology,Nantong First People's Hospital,Nantong 226000,China)
出处
《武警后勤学院学报（医学版）》
CAS
2020年第9期18-22,共5页
Journal of Logistics University of PAP（Medical Sciences）
基金
南通市卫生和计划生育委员会科研课题(MB2019009)
关键词
维持性血液透析
生长分化因子-15
钙磷代谢紊乱
左心室肥厚
Maintenance hemodialysis
Growth differentiation factor-15
Calcium and phosphorus metabolism disorder
Left ventricular hypertrophy
作者简介
姚娬斌,硕士,住院医师,主要从事肾脏病学研究。;通信作者:沈燕,硕士,主治医师,主要从事肾脏病学研究,E-mail:1532926528@qq.com。
