血液透析对患者血清碱性磷酸酶、骨硬化蛋白与骨代谢的影响

目的血液透析对患者血清碱性磷酸酶(ALP)、骨硬化蛋白(SOST)与骨代谢等指标的影响。方法选取本院2016年1月至2019年1月期间收治的血液透析患者116例为研究对象纳入观察组,另选同期在本院进行体检的50例健康受试者为对照组。采用酶联免疫吸附试验法对两组患者入院时的ALP、SOST、骨代谢指标:血清骨钙素(OC)、β胶原蛋白(β-CTX)、I型前胶原氨基末端前肽(PINP)指标水平,并进行组间对比。对观察组患者进行维持性的血液透析治疗,并检测比较在患者透析治疗前、透析治疗1、6、12个月的各项指标水平。采用Pearson检验对观察组患者的ALP、SOST与骨代谢指标的相关性进行分析。结果与对照组比较,观察组患者血液透析治疗前ALP、SOST、OC、β-CTX、PINP等指标均低于对照组受试者各项指标水平,组间比较差异有统计学意义(P<0.05)。观察组患者中随着透析治疗时间的延长,患者的ALP、SOST、OC、β-CTX、PINP等指标水平均明显上升,各时间点间比较差异有统计学意义(P<0.05)。经Pearson检验分析,血液透析患者的ALP、SOST与骨代谢指标OC、β-CTX、PINP呈正相关性。结论血液透析患体内的ALP、SOST、骨代谢指标均呈现异常降低,经持续性血液透析治疗患者的ALP、SOST、骨代谢指标均有改善,且ALP、SOST与骨代谢指标OC、β-CTX、PINP呈正相关性。

Effect of hemodialysis on serum alkaline phosphatase,osteosclerosis protein and bone metabolism in patients

Objective  To study the effects of hemodialysis on serum alkaline phosphatase(ALP),osteosclerosis protein(SOST) and bone metabolism. Methods  From January 2016 to January 2019,116 hemodialysis patients admitted to our hospital were selected as the study group, and 50 healthy subjects who underwent physical examination in our hospital during the same period were selected as the control group. The levels of ALP,SOST and bone metabolic indexes including serum osteocalcin(OC),beta collagen(beta-CTX) and type I procollagen amino terminal propeptide(PINP) were measured by ELISA at admission and compared between the two groups. The patients in the observation group were treated with maintenance hemodialysis, and the levels of indicators before dialysis treatment,1,6 and 12 months after dialysis treatment were detected and compared. Pearson test was used to analyze the correlation between ALP,SOST and bone metabolism index in the observation group.Results  Compared with the healthy control group,ALP,SOST,OC,beta-CTX, PINP and other indicators in the observation group before hemodialysis were lower than those in the control group, and there was significant difference between the two groups(P<0.05). The levels of ALP,SOST,OC,beta-CTX,PINP and other indicators in the observation group increased significantly with the prolongation of dialysis treatment time, and there were significant differences between the time points(P<0.05). Pearson test showed that ALP, SOST were positively correlated with bone metabolic indexes OC,beta-CTX and PINP in hemodialysis patients. Conclusions  ALP, SOST and bone metabolic indexes in patients with hemodialysis are abnormally decreased. ALP, SOST and bone metabolic indexes in patients treated with continuous hemodialysis are improved,and ALP and SOST are positively correlated with bone metabolic indexes OC, beta-CTX and PINP.