骨化三醇联合腹膜透析疗法治疗慢性肾功能衰竭的临床疗效及对患者血清ProGRP、Cysc、Chemerin水平的影响  

Clinical Efficacy of Calcitriol Combined with Peritoneal Dialysis in the treatment of Chronic Renal Failure and its Effects on the Serum ProGRP,Cysc and Chemerin Levels

作　　者：李丹[1] 李杨[1] 丁小明[1] 王华[1] 朱晓荣 LI Dan;LI Yang;DING Xiao-ming;WANG Hua;ZHU Xiao-rong(Department of Kidney Transplantation,First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi,710061,China)

机构地区：[1]西安交通大学第一附属医院肾移植科

出　　处：《现代生物医学进展》2019年第21期4176-4179,4187,共5页Progress in Modern Biomedicine

基　　金：陕西省自然科学基金项目(20140127)

摘　　要：目的:探讨骨化三醇联合腹膜透析疗法治疗慢性肾功能衰竭的临床疗效及对患者血清Pro-Gastrin-Releasing Peptide (ProGRP)、CystatinC(Cysc)、Chemerin水平的影响。方法:选取我院2017年2月至2018年1月收治的98例慢性肾功能衰竭患者,按照随机数表法将其分为观察组(n=51)和对照组(n=47)。对照组采用腹膜透析疗法治疗,观察组采用骨化三醇联合腹膜透析疗法治疗。观察和比较两组治疗前后肾功能指标尿素氮(blood urea nitrogen,BUN)、血清肌酐(Serum creatinine Cr)、24小时尿蛋白(24 h urinary protein,24 h UP),生化指标白蛋白(albumin,Alb)、血红蛋白(hemoglobin,Hb)及红细胞(red blood cell,RBC),胃泌素释放肽前体(ProGRP)、血清胱抑素(Cys C)、趋化素(Chemerin)水平的变化,6个月、1年生存率及不良反应的发生情况。结果:治疗后,观察组BUN、SCr、24hUP水平均显著低于对照组[(13.95±3.06)mmol/L vs.(21.10±3.85)mmol/L,(260.12±40.32)μmol/L vs.(354.93±51.06)μmol/L,(1.75±0.45)g/24 h vs.(2.67±0.80)g/24 h](P<0.05);Alb水平显著低于对照组[(27.85±3.58)g/L vs.(33.06±4.27)g/L](P<0.05);Hb、RBC显著高于对照组[(91.72±13.46)g/L vs.(82.36±10.15)g/L,(379.47±92.08)×1012/L vs.(315.70±73.24)×1012/L](P<0.05);ProGRP、Chemerin水平显著低于对照组[(49.23±4.72)pg/mL vs.(63.87±7.30)pg/mL,(37.02±6.15)μg/L vs.(30.63±4.81)μg/L](P<0.05);Cysc水平显著高于对照组[(80.75±16.08)mL/min vs.(98.81±18.07)mL/min](P<0.05);6个月、1年生存率均显著高于对照组[96.08%(49/51) vs. 91.49%(43/47),90.20%(46/51) vs. 74.47%(35/47)](P<0.05);不良反应总发生率显著低于对照组[17.65%(9/51) vs. 44.68%(21/47)](P<0.05)。结论:骨化三醇联合腹膜透析疗法治疗慢性肾功能衰竭的临床效果显著优于单用,其可有效减轻患者的临床症状,纠正电解质紊乱,改善肾功能和预后,可能与降低血清ProGRP、Chemerin水平及提高血清Cysc水平有关。Objective: To explore the clinical efficacy of calcitriol combined with peritoneal dialysis in the treatment of chronic renal failure and its effects on the serum ProGRP, Cysc and Chemerin levels. Methods: 98 patients with chronic renal failure who were treated from February 2017 to January 2018 in our hospital were selected as the research objects. According to the random number table,those patients were divided into the observation group(n=47) and the control group(n=51). The control group was treated with peritoneal dialysis, while the observation group treated with Calcitriol combined with peritoneal dialysis. The changes of blood urea nitrogen(BUN), serum creatinine(Cr), 24-hour urinary protein(24-hour UP), albumin(Alb), hemoglobin(Hb), red blood cell(RBC), gastrin-releasing peptide precursor(ProGRP), serum Cys C and Chemerin levels before and after treatment, 6-month and 1-year survival rates as well as the incidence of adverse reactions were compared between two groups. Results: After treatment, the BUN, SCr and 24 hUP levels in the observation group were significantly lower than those in the control group [(13.95 ±3.06)mmol/L vs.(21.10 ±3.85)mmol/L,(260.12±40.32) μmol/L vs.(354.93±51.06) μmol/L,(1.75±0.45)g/24 h vs.(2.67±0.80)g/24 h](P<0.05). The Alb level was significantly lower than that of the control group [(27.85±3.58)g/L vs.(33.06±4.27)g/L](P<0.05). The Hb and RBC were significantly higher than those in the control group[(91.72±13.46)g/L vs.(82.36±10.15)g/L,(379.47±92.08)×1012/L vs(315.70±73.24)×1012/L](P<0.05).Pro GRP and Chemerin levels were significantly lower than those in the control group [(49.23±4.72) pg/mL vs.(63.87±7.30) pg/mL,(37.02±6.15)μg/L vs.(30.63±4.81)μg/L](P<0.05). The Cysc level was significantly higher than that of control group [(80.75±16.08)ml/min vs.(98.81±18.07)ml/min](P<0.05). The 6-month and 1-year survival rates were significantly higher than those in the control group[96.08%(49/51) vs.91.49%(43/47), 90.20%(46/51) vs.74.47%(35/47)](P<0.05). The total

关 键 词：骨化三醇 腹膜透析疗法 慢性肾功能衰竭 肾功能 

分 类 号：R459.5[医药卫生—治疗学] R692.5[医药卫生—临床医学]