关键词: 终末期肾病, 成纤维细胞生长因子21, 透析方式, 血脂炎症

Abstract:

Ｏｂｊｅｃｔｉｖｅ：To compare the effect of different dialysis methods on the plasma levels of fibroblast growth factor21（FGF21）in patients with end stage renal disease (ESRD) and to investigate the correlation between the FGF21 and the qualities of the patients lives.
Ｍｅｔｈｏｄｏｌｏｇｙ：Two hundred eleven subjects including 80 peritoneal dialysis patients （PD）, 47 hemodialytic patients（HD）, 42 ESRD patients without dialysis （ESRD）and 42 healthy control subjects were recruited. Clinical and laboratory data were collected,. The plasma levels of FGF21 and adiponectin were estimated by enzymelinked immunosorbent（ELISA）and the clinical and biochemical parameters such as renal function, glucose and lipid metabolism, inflammation, nutrition state, calcium phosphorus metabolism and cardiac function were measured. Grouping comparison、Correlation analysis and multivariate regression analysis were performed．
Ｒｅｓｕｌｔｓ：Plasma FGF21 levels in HD group was significantly higher than that in PD group (P<001). However, there was no significant difference in plasma FGF21 level between PD group and ESRD group (P>005). For patients with ESRD, the plasma FGF21 levels in patients with residual renal function were significantly lower than those in patients without residual renal function，The plasma FGF21 levels in patients with left ventricular hypertrophy were significantly higher than those in patients without left ventricular hypertrophy, the difference was statistically significant (P<001). There was no correlation between plasma FGF21 level and sex, diabetes, coronary heart disease in ESRD patients (P>005). Furthermore, the plasma FGF21 levels in ESRD patients correlated positively with ADPN and CRP, but negatively with TC, LDL and EF % (all P<005). Multiple linear regression analysis indicated that plasma FGF21 was independently associated with ADPN and LDL (P<005)；
Ｃｏｎｃｌｕｓｉｏｎ：The levels of plasma FGF21 in patients with different dialysis methods were different, and plasma FGF21 levels in ESRD patients were closely related to inflammation, plasma lipids and cardiac function parameters.