不同血液净化方式对维持性血液透析患者骨代谢的影响

 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。

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

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.