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、iPTH、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。
Abstract
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, iPTH, 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
Key words
hemodialysis /
hemodiafiltration /
hemoperfusion /
bone metabolism
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