| 朱华威.不同血液透析对患者矿物质骨异常影响分析[J].浙江中西医结合杂志,2018,28(12): |
| 不同血液透析对患者矿物质骨异常影响分析 |
| Analysis of the effect of different hemodialysis on the abnormality of mineral and bone in patients |
| 投稿时间：2018-03-06 修订日期：2018-11-09 |
| DOI： |
| 中文关键词: 血液透析 血液透析滤过 血液灌流 终末期肾脏病 矿物质骨异常 |
| 英文关键词:hemodialysis hemodialysis filtration hemoperfusion end-stage renal disease mineral bone abnormality |
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| 中文摘要: |
| 目的：探讨分析不同血液透析对患者矿物质骨异常的影响。方法：选择我院收治的慢性肾功能衰竭且维持性血液透析12个月以上患者106例，根据患者透析方式将其分为A组43例、B组3例、C组33例，A组给予低通量透析、B组给予高通量透析、C组给予高通量透析滤过，观察时间6个月，分析三组患者血磷、血钙、全段甲状旁腺素（iPTH）、I型前胶原氨基末端肽（PINP）、成纤维生长因子23（FGF-23）、骨质疏松患病率等指标变化情况。结果：A组患者治疗6个月Ca、P、iPTH、PINP、FGF-23水平均无明显变化（P>0.05）；B组患者治疗6个月iPTH水平显著降低（P<0.05），Ca、P、PINP、FGF-23水平无明显变化（P>0.05）；C组患者治疗6个月iPTH、PINP、FGF-23水平显著降低（P<0.05），Ca、P水平无明显变化（P>0.05）。组间比较，B组、C组治疗6个月iPTH水平明显低于A组（P<0.05），治疗6个月C组PINP、FGF-23水平明显低于A组、B组（P<0.05）。治疗6个月三组患者骨质疏松患病率与入组时比较均无明显变化（P>0.05），且三组骨质疏松患病率比较无明显差异（P>0.05）。透析6个月后，三组血清钙、磷以及钙磷乘积达标率均无显著差异（P>0.05），C组iPTH达标率显著高于A组（P<0.05）。结论：不同血液透析方式对维持性血液透析患者矿物质骨代谢影响有所不同，高通量血液透析与低通量透析相比较，更有利于患者矿物质骨代谢指标的改善，且高通量血液透析滤过在骨代谢指标改善方面更具优势。 |
| 英文摘要: |
| Objective: The effects of different hemodialysis on the abnormality of mineral and bone in patients were analyzed and analyzed. Methods: chronic renal failure in our hospital and 106 cases of maintenance hemodialysis patients for more than 12 months, according to the dialysis patients were divided into A group of 43 cases, 30 cases in B group, 33 cases in C group, A group, B group received low flux dialysis for high flux dialysis and C groups high flux dialysis filtration. The observation time of 6 months, of the three groups of patients with serum phosphorus, serum calcium, parathyroid hormone (iPTH), type I procollagen amino terminal peptide (PINP), fibroblast growth factor 23 (FGF-23), the prevalence rate of osteoporosis and other indicators of changes. Results: there were no significant changes in the level of Ca, P, iPTH, PINP and FGF-23 in group A for 6 months (P>0.05). In group B, the level of iPTH was significantly decreased for 6 months(P<0.05). There was no significant change in the levels of Ca, P, PINP and FGF-23 (P>0.05). In group C, the level of iPTH, PINP and FGF-23 decreased significantly for 6 months (P<0.05), and there was no significant change in Ca and P levels (P>0.05). Between groups, iPTH level in group B and group C was significantly lower than that in group A at 6 months (P<0.05). After 6 months treatment, the levels of PINP and FGF-23 in C group were significantly lower than those in A group and B group (P<0.05). After 6 months of treatment, there was no significant difference in the prevalence of osteoporosis between the three groups(P>0.05), and there was no significant difference in the prevalence of osteoporosis between the three groups (P>0.05). After 6 months of dialysis, there was no significant difference in the standard rate of serum calcium, phosphorus and calcium and phosphorus in the three groups (P>0.05), and the standard rate of iPTH in group C was significantly higher than that in group A (P<0.05). Conclusion: different dialysis modalities on bone mineral metabolism in maintenance hemodialysis patients have different effects, high flux hemodialysis and low flux hemodialysis in comparison, more conducive to bone mineral metabolism in patients with improvement of the index, and high flux hemodiafiltration on bone metabolism index improved more advantages. |
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