血液透析联合血液灌流治疗老年血液透析患者肾性骨病效果分析及对患者炎症反应、骨形态发生蛋白、血钙/磷和甲状腺素水平的影响研究  

Effect of hemodialysis combined hemoperfusion on the renal osteodystrophy and its influences on serum inflammatory factors,BMPs,serum calcium / phosphorus and thyroxine

作　　者：刘维佳[1] 黄俊波[1] 

机构地区：[1]长江大学附属仙桃市第一人民医院肾内科,湖北仙桃433000

出　　处：《临床和实验医学杂志》2017年第3期237-240,共4页Journal of Clinical and Experimental Medicine

基　　金：仙桃市科学技术局2013年指导性科技研究与开发计划项目(2013-1)

摘　　要：目的对血液透析联合血液灌流治疗老年血液透析患者肾性骨病效果进行分析,以及对患者炎症反应、骨形态发生蛋白、血钙/磷和甲状腺素水平的影响,为临床治疗提供参考。方法选取2010年5月至2015年11月期间诊治的维持性透析的肾性骨病患者200例进行研究,分析患者经单纯性血液透析(对照组,n=100)和血液透析联合血液灌流(观察组,n=100)治疗的效果。并比较两组患者治疗后血清中炎症反应蛋白、骨形态发生蛋白、血钙/磷和甲状腺激素水平变化。结果对照组相比,观察组患者治疗后的总有效率明显升高(P<0.05);治疗后两组患者血清中白细胞介素IL-1β、IL-2、IL-6和IL-10及血磷水平明显降低(P<0.05),而血钙水平明显升高(P<0.05),甲状腺激素水平明显降低,而内皮生长因子(VEGF)、肿瘤坏死因子β(TGF-β)、骨形态发生蛋白BMP3、BMP7和BMP9水平明显升高(P<0.05),且观察组治疗后变化更显著(P<0.05)。结论血液透析联合血液灌流能有效治疗老年血液透析患者肾性骨病,且其作用可能与调节患者炎症反应蛋白及骨形态发生蛋白、血钙/磷和甲状腺激素水平相关。Objective The present research aimed to explore the effect of hemodialysis combined hemoperfusion on the renal osteodystrophy and its influences on the inflammatory response,bone morphogenetic protein,serum calcium / phosphorus and thyroxine levels.Methods 200 cases of renal osteodystrophy patients in our hospital from May 2010 to Nov 2015 were enrolled in this study.All the patients were divided into 2groups：hemodialysis group（ control group） and hemodialysis combined hemoperfusion group（ observed group）.The serum levels of inflammatory response protein,bone morphogenetic protein,serum calcium / phosphorus and thyroid hormone were compared between the two groups after treatment.Results The effect in observed group were obvious than that of the control group（ P〈0.05）.The serum IL-1,IL-2,IL-6,IL-10 and phosphorus were decreased while the calcium was increased greatly（ P〈0.05）.The results also showed that the VEGF,TGF-β and BMPs were increased after treatment（ P〈0.05）.Conclusion Hemodialysis combined hemoperfusion are effective on the renal osteodystrophy which may be relate with the regulation on serum inflammatory factors,bone morphogenetic protein,serum calcium / phosphorus and thyroid hormone.

关 键 词：肾性骨病 血液透析 血液灌流 炎症反应 骨形态发生蛋白 

分 类 号：R692.5[医药卫生—泌尿科学] R681[医药卫生—外科学]