不同血液净化方式对维持性血液透析患者成纤维细胞生长因子-23清除效果的研究

Research on clearance of fibroblast growth factor-23 of maintenance hemodialysis patients by different blood purification methods

目的探讨不同血液净化方式对维持性血液透析(MHD)患者成纤维细胞生长因子-23(FGF-23)的清除效果。方法选取MHD患者120例为研究对象,随机分为低通量透析组(HD)、血液透析滤过组(HDF)、高通量透析组(HFHD),每组40例,治疗6个月,分别检测治疗前后血钙(Ca)、血磷(P)、碱性磷酸酶(ALP)、甲状旁腺素(PTH)、FGF-23水平的变化。结果 (1)三组患者治疗前后血Ca水平差异均无统计学意义(P>0.05);(2)HD组治疗前后血P、ALP、PTH、FGF-23水平差异均无统计学意义(P>0.05),HDF组和HFHD组治疗后血P、ALP、PTH、FGF-23水平与治疗前相比均明显下降(P<0.05),与HDF组相比,HFHD组PTH和FGF-23水平下降更明显(P<0.05)。结论与HD及HDF相比,HFHD能更有效清除FGF-23,降低MHD患者肾性骨病发生率。

Objective To analyse the clearance effects of fibroblast growth factor - 23 （ FGF - 23 ） of maintenance hemo- dialysis（MHD） patients by different blood purification methods. Methods Totally 120 MHD patients were selected and divided into three groups ： hemodialysis （ HD ）, hemodlafihration （HDF） and high flux hemodialysis （ HFHD ）. There were 40 patients in each group. Patients in every group were treated by different blood purification methods for six months. Calcium, phosphorus, alkaline phosphatase（ALP）, parathyroid hormone（PTH）, FGF-23 were detected be- fore and after six months of treatment. Results ①There was no significant difference of Calcium before and after treat- ment in each group（ P 〉 0. 05 ） ; ②There was no significant difference of phosphorus, ALP, PTH and FGF - 23 before and after treatment in HD group（ P 〉0. 05 ） ; After six months of treatment, phosphorus, ALP, PTH and FGF - 23 were significant decreased in HDF and HFHD group compared with pre - treatment ; PTH and FGF - 23 in HFHD group were lower than that in HDF group after treatment （P 〈 0. 05 ）. Conclusion Compared with HD and HDF, HFHD can clear FGF -23 more effectively, and may play a role in decreasing occurrence rate of renal osteopathy.