[1]王岩,张爱霞,王紫晖,等.碱性成纤维细胞生长因子、血清和糖皮质激素诱导的蛋白激酶3表达与血液透析患者动静脉内瘘失功的关系[J].新乡医学院学报,2023,40(9):851-855.[doi:10.7683/xxyxyxb.2023.09.009]
　WANG Yan,ZHANG Aixia,WANG Zihui,et al.Relationship between the expression of basic fibroblast growth factor,serum and glucocorticoid-induced protein kinase 3 and the dysfunction of arteriovenous fistula in patients undergoing hemodialysis[J].Journal of Xinxiang Medical University,2023,40(9):851-855.[doi:10.7683/xxyxyxb.2023.09.009]
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碱性成纤维细胞生长因子、血清和糖皮质激素诱导的蛋白激酶3表达与血液透析患者动静脉内瘘失功的关系
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
40卷
期数:
2023年9
页码:
851-855
栏目:
临床研究
出版日期:
2023-09-05

文章信息/Info

Title:
Relationship between the expression of basic fibroblast growth factor,serum and glucocorticoid-induced protein kinase 3 and the dysfunction of arteriovenous fistula in patients undergoing hemodialysis
作者:
王岩; 张爱霞; 王紫晖; 王谦受
（洛阳市东方人民医院血液净化科，河南　洛阳　471003）
Author(s):
WANG Yan; ZHANG Aixia; WANG Zihui; WANG Qianshou
（Department of Blood Purification，Luoyang Dongfang People′s Hospital，Luoyang 471003，Henan Province，China）
关键词:
碱性成纤维细胞生长因子; 血清和糖皮质激素诱导的蛋白激酶3; 血液透析; 动静脉内瘘
Keywords:
basic fibroblast growth factor; serum and glucocorticoid-induced protein kinase 3; hemodialysis; arteriovenous fistulas
分类号:
R459.5
DOI:
10.7683/xxyxyxb.2023.09.009
文献标志码:
A
摘要:
目的　探讨碱性成纤维细胞生长因子（b-FGF）、血清和糖皮质激素诱导的蛋白激酶3（SGK3）表达与血液透析（HD）患者动静脉内瘘（AVF）失功的关系。
方法　选择2019年1月至2021年12月在洛阳市东方人民医院接受HD的80例患者为研究对象（观察组），另选择同期入院体检健康者30例作为对照组。根据是否伴有AVF失功将观察组患者分为AVF失功组（n=31）和AVF未失功组（n=49）。采用酶联免疫吸附法检测所有受试者血清中b-FGF水平，采用免疫组织化学法检测血清中SGK3水平；并比较观察组和对照组受试者血清中b-FGF、SGK3水平。收集观察组患者的临床资料，采用单因素和多因素logsitic回归分析HD患者发生AVF失功的危险因素，并重点观察血清b-FGF、SGK3水平与HD 患者AVF失功的关系。绘制受试者操作特征（ROC）曲线评估b-FGF、SGK3对HD 患者发生AVF失功的预测价值。
结果　观察组患者血清中b-FGF、SGK3水平显著高于对照组（P<0.05）。单因素分析结果显示，AVF失功组与AVF未失功组患者的年龄、透析时间、透析频率、白细胞（WBC）计数、血细胞比容（Hct）、中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）、血小板（PLT）计数及b-FGF、SGK3、空腹血糖（FPG）、肌钙蛋白T（TnT）、降钙素原（PCT）、血尿酸（UA）、高密度脂蛋白（HDL）水平和糖尿病史、抽烟史占比比较差异有统计学意义（P<0.05）；logistic回归分析结果显示，高b-FGF、SGK3、NLR、PLR水平及透析频率和长时间透析是HD患者发生AVF失功的独立危险因素（P<0.05）。ROC曲线分析结果显示，血清b-FGF预测HD患者发生AVF失功的灵敏度、特异度分别为85.96%、69.57%，血清SGK3预测HD患者发生AVF失功的灵敏度、特异度分别为 87.72%、73.91%；二者联合检测预测HD患者发生AVF失功的灵敏度、特异度分别为91.53%、85.71%。
结论　HD导致AVF失功患者血清中b-FGF、SGK3水平升高，二者联合检测对HD患者发生AVF失功具有较高的预测效能，可将其作为预测HD患者 AVF失功的有效因子，为临床预防、优化治疗措施提供帮助。
Abstract:
Objective　To investigate the relationship between the expression of basic fibroblast growth factor (b-FGF),serum and glucocorticoid-induced protein kinase 3 (SGK3) and the dysfunction of autogenous arteriovenous fistulas (AVF) in hemodialysis (HD) patients.
Methods　A total of 80 patients who received HD in Luoyang Dongfang People′s Hospital from January 2019 to December 2021 were selected as the study subjects (observation group),and 30 healthy individuals who underwent physical examination during the same period were selected as the control group.The patients in the observation group were divided into AVF dysfunction group (n=31) and AVF non-dysfunction group (n=49) according to whether they were accompanied with AVF dysfunction.The serum b-FGF level of all subjects was detected by enzyme linked immunosorbent assay,the serum SGK3 level of all subjects was detected by immunohistochemistry;and the serum b-FGF,SGK3 levels of all subjects were compared between the observation group and the control group.The clinical data of patients in the observation group were collected,and the risk factors of AVF dysfunction in HD patients were analyzed by univariate and multifactorial logsitic regression,and the relationship between serum b-FGF,SGK3 levels and AVF dysfunction in HD patients was mainly observed.Receiver operating characteristic (ROC) curve was drawed to evaluate the predictive value of b-FGF and SGK3 for AVF dysfunction in HD patients.
Results　The serum levels of b-FGF and SGK3 of patients in the observation group were significantly higher than those in the control group (P<0.05).The results of univariate analysis showed that there was significant difference in the age,dialysis time,dialysis frequency,white blood cell (WBC) count,hematocellular volume (Hct),neutrophil/lymphocyte ratio (NLR),platelet/lymphocyte ratio (PLR),platelet (PLT) count and b-FGF,SGK3,fasting blood glucose (FPG),troponin T (TnT),procalcitonin (PCT),blood uric acid (UA),high-density lipoprotein (HDL) levels and the proportion of diabetes history and smoking history of patients between the AVF dysfunction group and AVF non-dysfunction group (P<0.05).Logistic regression analysis showed that high b-FGF,SGK3,NLR,PLR levels,dialysis frequency and long dialysis time were independent risk factors for AVF dysfunction in HD patients(P<0.05).ROC curve analysis results showed that the sensitivity and specificity of serum b-FGF in predicting AVF dysfunction in HD patients were 85.96% and 69.57%,respectively and the sensitivity and specificity of serum SGK3 in predicting AVF dysfunction in HD patients were 87.72% and 73.91%,respectively;the sensitivity and specificity of the combined detection of b-FGF and SGK3 in predicting AVF dysfunction in HD patients were 91.53% and 85.71%,respectively.
Conclusion　Serum levels of b-FGF and SGK3 in patients with AVF dysfunction after HD are increased,and the combined detection of the two indexes has high predictive efficacy for AVF dysfunction in HD patients,which could be used as an effective factor to predict AVF dysfunction in HD patients,and provide help for clinical prevention and optimization of treatment measures.

参考文献/References:

［1］　王岩,张爱霞,王紫晖,等.高通量血液透析与联机血液透析滤过联合治疗慢性肾衰竭疗效观察［J］.新乡医学院学报,2022,39(6):573-577.
WANG Y,ZHANG A X,WANG Z H,et al.Curative effect of high-flux hemodialysis combined with online hemodiafiltration in the treatment of chronic renal failure［J］.J Xinxiang Med Univ,2022,39(6):573-577.
［2］　PIRYANI A K,KILARI S,TAKAHASHI E,et al.Rationale and trial design of mesenchymal stem cell trial in preventing venous stenosis of hemodialysis vascular access arteriovenous fistula (MEST AVF Trial)［J］.Kidney 360,2021,2(12):1945-1952.
［3］　LI Y,CUI W,WANG J,et al.Factors associated with dysfunction of autogenous arteriovenous fistula in patients with maintenance hemodialysis:a retrospective study［J］.Ann Palliat Med,2021,10(4):4047-4054.
［4］　DU J,KONG X,LIANG L,et al.Plasma D-dimer level and the failure of forearm autologous arteriovenous fistula in patients with end-stage renal disease［J］.Ther Apher Dial,2020,24(4):400-407.
［5］　张志坚,陈涵枝,刘斌,等.血清成纤维细胞生长因子23在桡动脉钙化及动静脉内瘘失功中的预测作用［J］.中国血液净化,2021,20(6):410-414.
ZHANG Z J,CHEN H Z,LIU B,et al.Serum fibroblast growth factor-23(FGF-23)level for predicting radial artery calcification and arterio-venous fistula dysfunction in hemodialysis patients［J］.Chin J Blood Purif,2021,20(6):410-414.
［6］　CASARI G,RESCA E,GIORGINI A,et al.Microfragmented adipose tissue is associated with improved ex vivo performance linked to HOXB7 and b-FGF expression［J］.Stem Cell Res Ther,2021,12(1):481.
［7］　NALAIRNDRAN G,HASSAN ABDUL RAZACK A,MAI C W,et al.Phosphoinositide-dependent kinase-1 (PDPK1) regulates serum/glucocorticoid-regulated kinase 3 (SGK3) for prostate cancer cell survival［J］.J Cell Mol Med,2020,24(20):12188-12198.
［8］　KIM J,KIM D,JUNG H,et al.Identification and kinetic characterization of serum- and glucocorticoid-regulated kinase inhibitors using a fluorescence polarization-based assay［J］.SLAS Discov,2021,26(5):655-662.
［9］　JIANG F,LIU H,PENG F,et al.Complement C3a activates osteoclasts by regulating the PI3K/PDK1/SGK3 pathway in patients with multiple myeloma［J］.Cancer Biol Med,2021,18(3):21-33.
［10］　CHEN J,ZHOU M,ZENG K,et al.The risk factors of autogenous arteriovenous fistula dysfunction in maintenance hemodialysis patients and the curative effect of personalized nursing［J］.Am J Transl Res,2021,13(5):5107-5116.
［11］　SPILIOPOULOS S,GIANNIKOURIS I E,KATSANOS K,et al.Volume flow assistance for optimizing outcomes of dysfunctional autologous arteriovenous fistula angioplasty:the VOLA pilot study［J］.Eur Radiol,2022,32(1):368-376.
［12］　ARAGONCILLO SAUCO I,HEVIA C,MANZANO GROSSI S,et al.Effect of preoperative exercise on vascular caliber and maturation of arteriovenous fistula:the physicalfav trial,a randomized controlled study［J］.J Nephrol,2021,34(3):763-771.
［13］　SEE Y P,CHO Y,PASCOE E M,et al.Predictors of arteriovenous fistula failure:a post hoc analysis of the FAVOURED study［J］.Kidney360,2020,1(11):1259-1269.
［14］　KALLER R,MURE� AN A V,ARB A~NA� I E M,et al.Uncommon surgical management by AVF between the great saphenous vein and anterior tibial artery for old radiocephalic AVF failure［J］.Life (Basel),2022,12(4):529.
［15］　QIAN J,YU J,ZHU X,et al.MiR-335 promotes corneal neovascularization by targeting EGFR［J］.BMC Ophthalmol,2022,22(1):267.
［16］　ABE S,SATO S,AONO Y,et al.Functional analysis of human fibrocytes derived from monocytes reveals their profibrotic phenotype through paracrine effects［J］.J Med Invest,2020,67(1.2):102-112.
［17］　YUAN Y F,ZHU W X,LIU T,et al.Cyclopamine functions as a suppressor of benign prostatic hyperplasia by inhibiting epithelial and stromal cell proliferation via suppression of the Hedgehog signaling pathway［J］.Int J Mol Med,2020,46(1):311-319.
［18］　HUO Q,XU C,SHAO Y,et al.Free CA125 promotes ovarian cancer cell migration and tumor metastasis by binding mesothelin to reduce DKK1 expression and activate the SGK3/FOXO3 pathway［J］.Int J Biol Sci,2021,17(2):574-588.
［19］　POKORNY D,TRUEBESTEIN L,FLEMING K D,et al.In vitro reconstitution of Sgk3 activation by phosphatidylinositol 3-phosphate［J］.J Biol Chem,2021,297(2):100919.
［20］　CEBECI A N,ZOU M,BINESSA H A,et al.Mutation of SGK3,a novel regulator of renal phosphate transport,causes autosomal dominant hypophosphatemic rickets［J］.J Clin Endocrinol Metab,2020,105(6):dgz260.

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更新日期/Last Update: 2023-09-05