两种血液净化方法对维持性血液透析患者血清FGF-23的影响

Two blood purification methods on clearing serum fibroblast growth factor-23 in maintenance hemodialysis patients

目的探讨血液透析、血液透析滤过对维持性血液透析患者血清成纤维细胞生长因子23(FGF-23)的清除效果。方法 60例维持性血液透析患者分为两组:血液透析组(HD组,n=30),血液透析滤过组(HDF组,n=30)。记录患者治疗前后血清FGF-23以及血钙(Ca)、血磷(P)、血清甲状旁腺激素(iPTH)等指标,并进行组内和组间统计学比较。结果 HD组血清FGF-23从治疗前(858.8±113.5)pg/ml降至治疗后(834.1±94.52)pg/ml,差异无统计学意义(P=0.2768);HDF组血清FGF-23从治疗前(782.5±105.8)pg/ml降至治疗后(712.0±98.05)pg/ml,差异有统计学意义(P=0.0037)。HDF组治疗后血清FGF-23较同期HD组明显降低(P=0.0067)。结论 HD对血清FGF-23无清除效果,HDF对血清FGF-23有清除作用。血清FGF-23对心血管疾病发生和发展有临床研究意义。

Objective To investigate the different clear effect between hemodialysis and hemodiafiltration on the serum fibroblast growth factor-23（FGF-23） in maintenance hemodialysis patients.Methods Sixty maintenance hemodialysis patients were divided into two groups according to on-going dialysis methods： hemodialysis group（HD group,n=30）,hemodiafiltration group（HDF group,n=30）.Serum pre-and post-treatment FGF-23,Ca,P,iPTH levels were measured,followed by statistical comparison within and between the groups,studied their correlations.Results The serum FGF-23 levels post-hemodialysis was decreased than pre-hemodialysis from（858.8±113.5）pg/ml to（834.1±94.52）pg/ml,the difference was insignificant（P=0.2768）.Hemodiafiltration techniques significantly decreased serum FGF-23 levels from（782.5±105.8）pg/ml to（712.0±98.05）pg/ml（P=0.0037）.Secondly,the serum FGF-23 levels in HDF group statistically reduced compared with the HD group（P=0.0067）.Conclusions Hemodialysis can not clear serum FGF-23.Hemodiafiltration can clear serum FGF-23 effectively.The serum FGF-23 make important part with cardiovascular diseases proceeding.