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目的：探究成纤维细胞生长因子23（FGF23）在终末期肾病患者继发性甲状旁腺功能亢进中的作用机制。方法：选取我院 2013 年2 月-2015 年5 月期间收治的58 例终末期肾病进入血液透析的患者，所有患者均经甲状旁腺CT 增强扫描，无增生及结节。按照iPTH 值将其分为两组，iPTH＞300 pg/mL为观察组，150 pg/mL≤ iPHT≤ 300 pg/mL为对照组，每组29 例。患者均予碳酸钙以及活性维生素D3进行治疗。对患者钙、磷、白蛋白、血脂以及FGF23、iPTH、1,25（OH）2D3进行检验。结果：治疗后观察组患者 FGF23 及iPTH均高于对照组，差异具有统计学意义（P＜0.05）。观察组血尿素氮、血肌酐与透析前相比明显下降，对照组血尿素氮、血肌酐与透析前相比明显下降，差异有统计学意义(P<0.01)；1,25（OH）2D3以及血白蛋白水平是影响Log FGF23 的独立影响因素。结论：FGF23 在终末期肾病患者继发性甲状旁腺功能亢进发病中发生作用，可作用临床诊断依据。

英文摘要:

Objective:To explore the role of fibroblast growth factor 23 (FGF23) in patients with end-stage renal disease.Methods:58 cases with end stage renal disease who were treated in our hospital from February 2013 to May 2015 were selected and according to the iPTH values, the patients were divided into two groups: iPTH > 300 pg / mL as the observation group, 150 pg/mL≤ iPHT≤ 300 pg/mL as the control group, with 29 patients in each group. Then the calcium, phosphorus, albumin, blood lipids, and levels of FGF23, iPTH, 1,25 (OH) 2D3 in the two groups were observed and compared.Results:The levels of FGF23 and iPTH in the observation group were significantly higher than those of the control group, and the differences were statistically significant (P<0.05). Compared with the control group, the blood urea nitrogen, creatinine and dialysis in the observation group significantly decreased, and the difference was statistically significant (P< 0.01); The FGF23 and iPTH decreased in the two groups, and the difference was statistically significant (P < 0.01). 1,25 (OH) 2D3 and serum albumin level were the independent influencing factors of FGF23 Log.Conclusion:FGF23 plays a role in the pathogenesis of secondary parathyroid function in patients with end-stage renal disease

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