血液灌流对维持性血液透析患者骨转化及心室结构的影响  

Effect of Hemodialysis and Hemoperfusion on the Bone Turnover and Ventricular Structure of Uremia Patients with Maintenance Hemodialysis

作　　者：陈望[1] 何晓东[1] 张鹏[1] 宋良月 孙天宇 

机构地区：[1]沈阳市第四人民医院老年病干诊科肾脏病区,110031

出　　处：《医学研究杂志》2018年第1期134-138,共5页Journal of Medical Research

基　　金：沈阳市卫生与计划生育委员会科研计划项目(沈卫办【2015】478号)

摘　　要：目的探讨血液透析与血液灌流对尿毒症维持性血液透析患者骨转化及心室结构的影响。方法选取2014年2月~2015年9月在笔者医院接受维持性血液透析治疗的124例尿毒症患者为研究对象,随机分为对照组与研究组,每组62例。对照组采用血液透析治疗,研究组采用血液透析联合血液灌流治疗,对所有患者均随访6个月。比较两组治疗前、治疗后6个月血钙(calcium,Ca)、血磷(phosphorus,P)、全段甲状旁腺素(intact parathyroid hormone,i PTH)、骨钙素(bone gla protein,BGP)、β-胶原降解产物(beta collagen degradation products,β-CTX)、血浆白蛋白(plasma-albumin,Alb)、Ⅰ型前胶原氨基端延长肽(type I collagen amino end before the extension of the peptide,P1NP)、β_2-微球蛋白(beta 2-microglobulin,β_2-MG)、超敏C反应蛋白(hypersensitive c-reactive protein,hs-CRP)、左心室舒张末径(left ventricular end-diastolic diameter,LVDd)、室间隔厚度(interventricular septal thickness,IVST)、舒张压(diastolic pressure,DBP)、收缩压(systolic pressure,SBP)、血红蛋白(hemoglobin,Hb)的变化情况。结果治疗6个月后,研究组Ca、Alb、β_2-MG、BGP、β-CTX、P1NP、hs-CRP、LVDd、IVST、DBP、SBP水平与对照组相比,差异均具有统计学意义(P<0.05);治疗6个月后,两组P及i PTH水平比较,差异无统计学意义(P>0.05)。结论对尿毒症维持性血液透析患者采用血液透析联合血液灌流进行治疗,可显著改善营养状态,减轻骨转化,改善心室结构的变化,具有临床推广意义。Objective To investigate the effect of hemodialysis and hemoperfusion on the bone turnover and ventricular structure of uremia patients with maintenance hemodialysis （MHD）. Methods A total of 124 uremia patients received MHD treatment in the hospital from February 2014 to September 2015 were randomly divided into control group and research group, 62 cases in each. Control group took hemodialysis and research group took hemodialysis combined with hemoperfusion. All the patients were given 6-month follow-up. The changes of calcium （Ca）, phosphorus （P）, intact parathyroid hormone （iPTH）, bone gla protein （BGP）, beta collagen degradation products （β-CTX）, plasma-albumin （Alb）, type Ⅰ collagen amino end before the extension of the peptide （P1NP）, beta 2-microglobulin （β2-MG）, hypersensitive c-reactive protein （hs-CRP）, left ventricular end-diastolic diameter （LVDd）, interventricular septal thickness （IVST）, diastolic pressure （DBP）, systolic pressure （SBP）, hemoglobin （Hb） of two groups before and after 6-month treatment were compared. Results After treatment for 6 months, the Ca, Alb, β2-MG, BGP, β-CTX, P1NP, hs-CRP, LVDd, IVST, DBP, SBP levels of research group were compared with control group, and there was statistical difference （P〈0.05）. After treatment for 6 months, the P and iPTH levels of two groups were compared, there was no statistical difference （P〉0.05）. Conclusion Hemodialysis and hemoperfusion for treating uremia patients with MHD can significantly improve nutritional status, reduce bone turnover, improve changes of ventricular structure, which has significance of clinical generalization.

关 键 词：血液透析 血液灌流 尿毒症 骨转化 心室结构 

分 类 号：R4[医药卫生—临床医学]