目的 探讨成纤维细胞生长因子受体-1( FGFR1)与Klotho蛋白在慢性肾衰竭( chronic renal failure， CRF )继发性甲状旁腺功能亢进症( secondary hyperparathyroidism， SHPT)甲状旁腺组织中的表达水平及其临床意义。方法 利用酶联免疫吸附测定( ELISA)检测30例SHPT组及6例无偿捐献的健康组术前术后血清成纤维细胞生长因子23( FGF23)水平， 采用化学发光酶免疫分析法检测全段甲状旁腺激素( iPTH)水平， 同时取SHPT组、健康组患者的甲状旁腺组织， 利用免疫组化方法检测FGFR1、Klotho蛋白表达， 计算FGFR1、Klotho蛋白的积分吸光度。结果 ( 1)SHPT组血清FGF23、PTH水平高于健康组( P<0.05);( 2)SHPT组结节性增生与弥漫性增生的甲状旁腺组织中FGFR1、klotho蛋白的表达低于健康组( P<0.05)。结论 与正常甲状旁腺组织相比， CRF合并SHPT患者甲状旁腺组织中FGFR1、Klotho蛋白表达水平降低， 尤其在结节性增生组织中比弥漫性增生组织中表现更加明显， 提示klotho-FGFR1系统在SHPT的发病机制中起着重要作用。

Objective To study the expressions of fibroblast growth factor receptor-1 ( FGFR1)and Klotho in the development of secondary hyperparathyroidism( SHPT) in chronic renal failure and their clinical significance. Methods 30 patients with SHPT were recruited to SHPT group. Six organ donors without renal disease were assigned to be normal group. All the subjects underwent detection of serum FGF23 and iPTH by ELISA and chemiluminescence enzyme immunoassay. The parathyroid glands were operated from normal and SHPT groups, and then the expression of FGFR1and Klotho in parathyroid gland tissue were detected by Immunohistochemistry. Absorbance was calculated. Results ( 1) Levels of serum FGF-23 and PTH of SHPT patients were increased significantly compared with control group( P<0.05). Serum FGF-23 was positively correlated with serum PTH in SHPT patients( P<0.05).( 2) The expression of FGFR1 and Klotho in the parathyroid glands with nodular hyperplasia and diffuse hyperplasia in SHPT group were all downregulated significantly compared with normal group( P<0.05). Conclusions The significant downregulation of FGFR1 and Klotho in parathyroid glands with nodular hyperplasia and diffuse hyperplasia of SHPT patients compared with normal group in parathyroid tissue maybe the main mechanism of SHPT.