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Heart：循环中FGF-23可以作为STEMI风险分层的新标志物！

2016-12-23 haofan MedSci原创

循环中FGF-23STEMI风险分层
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循环中FGF-23与再灌注的STEMI左室重塑独立相关。一个将FGF-23纳入其中的全面的多标记策略可以为预测左室重塑提供更多的预测价值。

ST段抬高的心肌梗死（STEMI）幸存者左心室（LV）的不良重塑是发生心力衰竭和死亡的主要因素。成纤维细胞生长因子23（FGF-23）对STEMI后左心室重构的预测作用仍为未知。近日，在心脏病领域权威杂志Heart上发表了一篇研究文章，研究人员旨在明确循环中FGF-23与血管重建的STEMI后左室重塑之间的关系。

在这项前瞻性观察性研究中，研究者共纳入88例经皮冠状动脉介入治疗的STEMI患者。研究人员在患者发病后2天（四分位间距：2-2天）测定FGF-23浓度，在发病后2天（四分位间距：1-3天）和心肌梗死后4个月（四分位间距：4-5月）进行心脏磁共振检查来评估患者左室重构情况，左室重构定义为左室舒张末期容积增加20%。

研究者发现，相比于那些没有发生左室重构的患者，发生了左室重构的患者（n=11，13%）FGF-23水平显着升高（152.6（102.5-241.3）vs. 75.8（58.6-105.4）相对单位/mL，P=0.002）。


对反映心肌坏死（高敏肌钙蛋白T，hs-cTnT）、心肌应激（N末端B型利钠肽前体，NT-proBNP）和炎症（高敏C反应蛋白，hs-CRP）的生物标志物进行调整后，FGF-23与左室重塑这种显著的相关性仍然存在（比值比为14.1，95%可信区间为2.8-70.9；P=0.001）。

此外，用多标记方法将FGF-23加入到已知的心室重构的预测性生物标志物（hs-cTnT、NT-proBNP和hs-CRP）导致净重分类指标提高了0.92（95%可信区间为0.44-1.41，P＜0.001）和综合判别指标提高了0.16（95%可信区间为0.08-0.24，P＜0.001）。

由此可见，循环中FGF-23与再灌注的STEMI左室重塑独立相关。一个将FGF-23纳入其中的全面的多标记策略可以为预测左室重塑提供更多的预测价值。

原始出处：

Martin Reindl,et al. Fibroblast growth factor 23 as novel biomarker for early risk
stratification after ST-elevation myocardial infarction. Heart. 2016. 

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    2017-05-15 654699882_84926995

    #FGF-23#

    0

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    2016-12-29 hukaixun

    #标志物#

    0

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    2017-02-14 ms8435843352634314

    #FGF-2#

    0

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    2017-01-03 1e10c84am36(暂无匿称)

    文章真好，已拜读

    0

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    2016-12-25 zhouqu_8

    #ART#

    0

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    2016-12-25 oliver169

    #风险分层#

    0

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    2016-12-25 12498bb3m92(暂无昵称)

    #STEM#

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1689418, encodeId=80981689418ce, content=<a href='/topic/show?id=c6c7e38638' target=_blank style='color:#2F92EE;'>#FGF-23#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7386, encryptionId=c6c7e38638, topicName=FGF-23)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b5eb28820445, createdName=654699882_84926995, createdTime=Mon May 15 01:02:00 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1840946, encodeId=171c184094630, content=<a href='/topic/show?id=18bf61953d3' target=_blank style='color:#2F92EE;'>#标志物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61953, encryptionId=18bf61953d3, topicName=标志物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ab940, createdName=hukaixun, createdTime=Thu Dec 29 18:02:00 CST 2016, time=2016-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2044863, encodeId=09aa2044863b7, content=<a href='/topic/show?id=efbee385a6' target=_blank style='color:#2F92EE;'>#FGF-2#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7385, encryptionId=efbee385a6, topicName=FGF-2)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqPdWFricgmt6Dde2ptNxJzD6Y9c4cxpXdTo4pNlVPARAnFdKu6nWIPele9icxApTaFgibq0uVlgRiceQ/132, createdBy=4b8c2500026, createdName=ms8435843352634314, createdTime=Tue Feb 14 20:02:00 CST 2017, time=2017-02-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=167658, encodeId=118316e65883, content=文章真好，已拜读, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Jan 03 10:11:16 CST 2017, time=2017-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356143, encodeId=6b151356143b2, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sun Dec 25 02:02:00 CST 2016, time=2016-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1360955, encodeId=7a76136095576, content=<a href='/topic/show?id=e372100861dc' target=_blank style='color:#2F92EE;'>#风险分层#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100861, encryptionId=e372100861dc, topicName=风险分层)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4fd6156, createdName=oliver169, createdTime=Sun Dec 25 02:02:00 CST 2016, time=2016-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1481950, encodeId=e58814819501e, content=<a href='/topic/show?id=8cc416e78f3' target=_blank style='color:#2F92EE;'>#STEM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16778, encryptionId=8cc416e78f3, topicName=STEM)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d1067833268, createdName=12498bb3m92(暂无昵称), createdTime=Sun Dec 25 02:02:00 CST 2016, time=2016-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562411, encodeId=1e0c156241147, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sun Dec 25 02:02:00 CST 2016, time=2016-12-25, status=1, ipAttribution=)]
    2016-12-25 slcumt

    #HEART#

    0