不同血液净化方式对维持性血液透析患者骨代谢的影响  

Effects of different blood purification methods on bone metabolism in maintenance hemodialysis patients

作　　者：郭志娟[1] 曹琰[1] 胡博 贾迎春 邱雪梅[1] GUO Zhijuan;CAO Yan;HU Bo;JIA Yingchun;QIU Xuemei(Department of Nephrology,General Hospital of Chinese People＇s Armed Police Force,Beijing 100039,China;Department of Radiology,Beijing Nuclear Industry Hospital,Beijing 100045,China)

机构地区：[1]武警总医院肾内科,北京100039 [2]北京核工业医院放射科,100045

出　　处：《武警医学》2018年第8期780-783,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨不同的血液净化方式对维持性血液透析患者骨代谢的影响。方法选取维持性血液透析患者105例,随机均分成3组:血液透析组(HD),血液透析+血液透析滤过组(HF)和血液透析+血液灌流组(HP)。治疗8个月后,检测各组血Ca、P、i PTH、beta-CTX、PINP和FGF23等骨代谢相关指标。结果与试验开始时相比,HD组的P[(2.73±0.83)vs(2.27±0.54)mmol/L]和PTH[(453.2±44.2)vs(438.7±41.0)pg/ml]水平显著升高(P<0.05),HF组的FGF23[(410.3±99.5)vs(450.7±88.6)ng/ml]水平显著下降(P<0.05),HP组PTH[(370.9±35.5)vs(458.3±49.2)pg/ml]、beta-CTX[(2.01±1.34)vs(2.74±1.26)ng/ml]和FGF23[(408.7±89.9)vs(459.9±76.1)ng/ml]水平均显著下降(P<0.05)。结论联合血液透析滤过,尤其是联合血液灌流较单纯血液透析改善骨代谢的效果更明显。Objective To investigate the effects of different blood purification technologies on bone metabolism in maintenance hemodialysis patients. Methods： A total of 105 patients were randomly divided into 3 groups： HD（ hemodialysis）,HF（ hemodialysis plus hemodiafiltration） and HP（ hemodialysis plus hemoperfusion）. After 8 months of intervention,bone metabolism biomarkers,such as Ca,P,i PTH,beta-CTX,PINP and FGF23,were detected. Results P [（ 2. 73 ± 0. 83） vs（ 2. 27 ± 0. 54） mmol/L] and PTH[（ 453. 2 ± 44. 2） vs（ 438. 7 ± 41. 0） pg/ml] levels significantly elevated in HD group（ P〈0. 05）,FGF23 [（ 410. 3 ± 99. 5） vs（ 450. 7 ± 88. 6） ng/ml]level in HF group markedly decreased（ P〈0. 05）,PTH [（ 370. 9 ± 35. 5） vs（ 458. 3 ± 49. 2） pg/ml]、beta-CTX [（ 2. 01 ± 1. 34） vs（ 2. 74 ± 1. 26） ng/ml]and FGF23 [（ 408. 7 ± 89. 9） vs（ 459. 9 ± 76. 1） ng/ml]levels in HP group significantly reduced（ P〈0. 05）. Conclusions Combined with hemodiafiltration,especially combined with hemoperfusion are more efficient on improving bone metabolism than hemodialysis alone in maintenance hemodialysis patients.

关 键 词：血液透析 血液透析滤过 血液灌流 骨代谢 

分 类 号：R318.16[医药卫生—生物医学工程]