杂合型血液净化治疗对慢性肾衰竭患者肾功能、FGF⁃23及炎性因子的影响  

Effect of heterogeneous blood purification therapy on renal function, FGF ⁃ 23 and inflammatory factors in patients with chronic renal failure

作　　者：许婉婷 朱小静 张爱红 罗雁归 XU Wanting;ZHU Xiaojing;ZHANG Aihong;LUO Yangui(Blood purification center,Xi'an People's Hospital/Xi'an Fourth Hospital,Xi'an,Shaanxi,China,710004)

机构地区：[1]西安市人民医院/西安市第四医院血液净化中心,陕西西安710004

出　　处：《分子诊断与治疗杂志》2024年第11期2090-2093,2098,共5页Journal of Molecular Diagnostics and Therapy

基　　金：陕西省自然科学基础研究计划(2020JM⁃326)。

摘　　要：目的探讨杂合型血液净化治疗对慢性肾衰竭(CRF)患者肾功能、成纤维细胞生长因子⁃23(FGF⁃23)及炎性因子的影响。方法选取2021年4月至2023年11月西安市人民医院收治的CRF患者72例,根据治疗方案的差异将其分为对照组(予以血液透析治疗,n=35)与观察组(予以杂合型血液净化治疗,n=37)。比较两组临床疗效、肾功能[血尿素氮(BUN)、血肌酐(SCr)、血肌酐清除率(Ccr)]、FGF⁃23及炎性因子水平[白介素⁃6(IL⁃6)、肿瘤坏死因子⁃α(TNF⁃α)、C反应蛋白(CRP)]、血液净化情况[血清β2微球蛋白(β2⁃MG)、甲状旁腺激素(PTH)、同型半胱氨酸(Hcy)]以及并发症发生情况。结果观察组(94.59%)的总有效率显著高于对照组(77.14%),差异有统计学意义(P<0.05);治疗后,两组BUN、SCr、IL⁃6、TNF⁃α、CRP、β2⁃MG、PTH、Hcy水平均下降,Ccr水平上升,且观察组BUN、SCr、IL⁃6、TNF⁃α、CRP、β2⁃MG、PTH、Hcy水平低于对照组,Ccr水平高于对照组,差异有统计学意义(P<0.05);两组总并发症发生率比较,差异无统计学意义(P>0.05)。结论杂合型血液净化疗法对CRF患者临床疗效显著,可有效改善其肾功能,降低FGF⁃23及炎性因子水平,提高血液净化效果,且具有一定的安全性。Objective To investigate the effects of heterogeneous blood purification therapy on renal function,fibroblast growth factor⁃23(FGF⁃23)and inflammatory factors in patients with chronic renal failure(CRF).Methods Seventy⁃two patients with CRF admitted to our hospital from April 2021 to November 2023 were selected for the study.They were divided into two groups:the control group(treated with hemodialysis,n=35)and the observation group(treated with heterogeneous hemodialysis,n=37)based on the differences in treatment protocols.Clinical efficacy,renal function markers[blood urea nitrogen(BUN),serum creatinine(SCr),serum creatinine clearance(Ccr)],FGF⁃23 levels,inflammatory factors[interleukin⁃6(IL⁃6),tumor necrosis factor⁃α(TNF⁃α),C⁃reactive protein(CRP)],blood purification markers[serumβ2 microglobulin(β2⁃mg),parathyroid hormone(CRP)](PTH),homocysteine(Hcy),and complications were assessed.Results The total effective rate of the observation group(94.59%)was significantly higher than that of the control group(77.14%)(P<0.05).After treatment,the levels of BUN,SCr,IL⁃6,TNF⁃α,CRP,β2⁃MG,PTH,and Hcy decreased,and the levels of Ccr,ALB,TP,and Hb increased in both groups.Additionally,the levels of BUN,SCr,IL⁃6,TNF⁃α,CRP,β2⁃MG,PTH,and Hcy in the observation group were lower than those in the control group,while the levels of Ccr,ALB,TP,and Hb were higher than those of the control group(P<0.05).There was no statistically significant difference in the total complication rate between the two groups(P>0.05).Conclusion Heterogeneous blood purification therapy has shown significant clinical efficacy in patients with CRF.This therapy can effectively improve renal function,reduce the levels of FGF⁃23 and inflammatory factors,and enhance the effect of blood purification.

关 键 词：杂合型血液净化 慢性肾衰竭 肾功能 FGF23 炎性因子 

分 类 号：R692.5[医药卫生—泌尿科学]