三种血液净化模式对慢性肾衰竭患者血清FGF23、β2-MG、瘦素及骨代谢指标的影响  

Effects of three blood purification modes on serum FGF23,β2-MG,leptin and bone metabolism indexes in patients with chronic renal failure

作　　者：郭晓凯[1] 罗冬平[1] 马向娟[2] 茹彦海 GUO Xiaokai;LUO Dongping;MA Xiangjuan;RU Yanhai(Department of Nephrology,The First Affiliated Hospital of Henan University of science and technology,Luoyang City,Henan Luoyang 471003,China;Department of blood purification,The First Affiliated Hospital of Henan University of science and technology,Luoyang City,Henan Luoyang 471003,China)

机构地区：[1]河南科技大学第一附属医院肾内科,河南洛阳471003 [2]河南科技大学第一附属医院血液净化科,河南洛阳471003

出　　处：《实验与检验医学》2023年第3期254-257,266,共5页Experimental and Laboratory Medicine

摘　　要：目的 探讨常规血液透析(HD)、高通量血液透析(HFHD)、组合型人工肾对慢性肾功能衰竭(CRF)患者血清成纤维细胞生长因子23(FGF23)、β2-微球蛋白(β2-MG)、瘦素以及骨代谢指标的影响。方法 选择2019年1月至2020年1月河南科技大学第一附属医院收治的105例CRF患者,随机数字表法分为3组,每组各35例,分别采用HD(HD组)、HFHD(HFHD组)、组合型人工肾(人工肾组)治疗。比较3组治疗前、治疗6个月(治疗后)肾功能、钙磷代谢以及血清FGF23、β2-MG、瘦素及骨代谢指标的差异。结果 人工肾组、HFHD组治疗后尿素氮(BUN)、血肌酐(SCr)、尿白蛋白排泄率(UAER)、P^(3-)、甲状旁腺激素(PTH)、FGF23、β2-MG、瘦素、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)水平均明显下降(P<0.05),Ca^(2+)、骨碱性磷酸酶(B-ALP)、Ⅰ型前胶原氨基端前肽(PINP)明显上升(P<0.05),HD组治疗后BUN、SCr、UAER降低(P<0.05),其它指标无明显变化(P>0.05)。人工肾组治疗后BUN、SCr、UAER、P^(3-)、PTH、FGF23、β2-MG、瘦素、β-CTX水平低于HFHD组和HD组(P<0.05),Ca^(2+)、B-ALP、PINP高于HFHD组和HD组(P<0.05)。HFHD组治疗后BUN、SCr、UAER、P^(3-)、PTH、FGF23、β2-MG、瘦素、β-CTX水平低于HD组(P<0.05),Ca^(2+)、B-ALP、PINP高于HD组(P<0.05)。结论 组合型人工肾更有助于清除FGF23、β2-MG、瘦素,改善CRF患者钙磷代谢、肾功能和骨代谢。Objective To investigate the effect of conventional hemodialysis(HD),High Flux Hemodialysis(HFHD)and Combined artificial kidney on serum fibroblast growth factor 23(FGF23),β2-microglobulin(β2-MG),leptin and bone metabolism in patients with chronic renal failure(CRF).Methods A total of 105 patients with CRF admitted to the hemodialysis center of the First Affiliated Hospital,Henan University of Science and Technology from January 2019 to January 2020 were selected and divided into three groups by random number table method,35 patients in each group were treated with HD(HD group),HFHD(HFHD group)and combined artificial kidney(Combined artificial kidney group)respectively.Renal function,calcium and phosphorus metabolism,serum FGF23,β2-MG,leptin and bone metabolism were compared between the 3 groups before and 6 months after treatment.Results Urea nitrogen(BUN),Serum creatinine(SCr),Urinary albumin excretion rate(UAER),P^(3-),Parathyroid hormone(PTH),FGF23β2-MG,Leptin,type I collagen breakdown products(β-CTX)levels in Combined artificial kidney group and HFHD group after treatment were significantly decreased(P<0.05),Ca^(2+),Bone alkaline phosphatase(B-ALP)and N-terminal propeptide of type I procollagen(PINP)increased significantly(P<0.05).In HD group,BUN,SCr and UAER were decreased after treatment(P<0.05),and other indexes had no significant change(P>0.05).After treatment,the levels of BUN,SCr,UAER,P^(3-),PTH,FGF23,β2-MG,Leptin,β-CTx in the Combined artificial kidney group were lower than those in the HFHD group and HD group(P<0.05),and the levels of Ca^(2+),B-ALP and PINP were higher than those in the HFHD group and HD group(P<0.05).The levels of BUN,SCr,UAER,P^(3-),PTH,FGF23,β2-MG,Leptin,β-CTx in the HFHD group were lower than those in the HD group(P<0.05),and the levels of Ca^(2+),B-ALP and PINP were higher than those in the HD group(P<0.05).Conclusion The combined artificial kidney is more helpful to remove FGF23,β2-MG,Leptin,and improve calcium and phosphorus metabolism,renal function and bone metabol

关 键 词：慢性肾衰竭 常规血液透析 高通量血液透析 成纤维细胞生长因子23 β2-微球蛋白 

分 类 号：R692.5[医药卫生—泌尿科学]