血液透析联合血液灌流在尿毒症患者中的应用及其对外周血FGF-23水平的影响和预后危险因素分析  

Application and effects of hemodialysis on peripheral blood FGF-23 levels and its risk factors influecing prognosis in patients with uremia

作　　者：丘宝珍 丘惠珍 温苑章[1] 张蔼玲[1] Qiu Baozhen , Qiu Huizhen , Wen Yuanzhang , Zhang Ailing(Department of Nephrology , Meizhou People＇ s Hospital, Meizhou 514031, Chin)

机构地区：[1]广东省梅州市人民医院肾内科,514031

出　　处：《临床医学》2018年第2期1-4,共4页Clinical Medicine

基　　金：梅州市市级医研类科技计划项目(2015B033)~~

摘　　要：目的探讨血液透析联合血液灌流在尿毒症患者中的应用及其对外周血FGF-23水平的影响和预后危险因素。方法选取尿毒症患者70例,随机将其分为对照组和观察组,每组35例。对照组患者采用普通血液透析治疗,观察组则在对照组的基础上加用血液灌流治疗。采用酶联免疫吸附测定法(ELISA)检测并比较两组患者治疗前后的血清FGF-23、血清IL-6、TNF-α水平。对两组患者进行为期1年的随访,对患者死亡情况进行单因素分析,并予以Logistic回归分析。结果治疗前两组患者血尿素氮、肌酐及血清瘦素水平、血清FGF-23水平、血清IL-6、TNF-α水平比较,差异未见统计学意义(P>0.05);治疗后观察组血尿素氮、肌酐及血清瘦素水平、血清FGF-23水平、血清IL-6、TNF-α水平低于对照组(P<0.05);治疗后,观察组并发症发生率(8.57%)低于对照组(17.1%)(P<0.05);透析前,死亡者Hb、Alb水平均低于存活者,并发症发生率高于存活者,差异有统计学意义(P<0.05)。经Logistic回归分析,透析前Hb、Alb水平是透析患者的保护因素,而并发症是患者的危险因素(P<0.05)。结论血液透析联合血液灌流治疗尿毒症效果显著,能改善外周血FGF-23水平,降低并发症发生率,且能有效缓解炎症反应。透析前Hb、Alb水平与并发症均与患者预后密切相关。Objective To investigate the application and effects of hemodialysis on peripheral blood FGF-23 levels and its risk factors influencing prognosis in patients with uremia. Methods Seventy patients with uremia were selected and randomly divided into control group and observation group,with35 cases in each group. The patients in control group were treated by normal blood dialysis,and the patients in observation group were treated by hemoperfusion on the basis of the treatment of the patients in control group. The serum FGF-23 levels,peripheral blood FGF-23 levels,serum IL-6 and TNF-alpha levels were detected by enzyme linked immunosorbent assay（ ELISA） before and after treatment,and then the results were compared between the two groups. The patients were followed-up for 1 year,and the death status was analzed. Results Before treatment,there were no significant differences in the blood urea nitrogen,creatinine,serum leptin,serum FGF-23 levels,serum IL-6 or TNF-α levels between the two groups（ P〈0. 05）; after treatment,the levels of blood urea nitrogen,creatinine,serum leptin,serum FGF-23,serum IL-6 and TNF-α of the patients in the observation group were significantly lower than those in the control group（ P〈0. 05）; the incidence of complication in observation group（ 8. 57%） was significantly lower than that in the control group（ 17. 1%,P〈0. 05）. Before hemodialysis,the Hb and Alb levels of the death were lower than those of the survival group,and the incidence of complications was higher than that of the survival group,the differences were significant（ P〈0. 05）. By logistic regression analysis,it can be obtained that before hemodialysis Alb level and Hb level was protective factor for hemodialysis patients,while complications were risk factors（ P〈0. 05）. Conclusions Hemodialysis combined with hemoperfusion has significant effect on patients with uremia,which can improve the level of FGF-23 in peripheral blood,lower the complication rate,and effectively improve the patient＇s i

关 键 词：血液透析 尿毒症 外周血FGF-23 酶联免疫吸附测定法 

分 类 号：R692.5[医药卫生—泌尿科学]