HFHD对尿毒症患者FGF-23、iPTH水平及心肺功能的影响

Effects of HFHD on FGF-23,iPTH levels and cardiopulmonary function in patients with uremia

目的探讨高通量血液透析(HFHD)对尿毒症患者血清成纤维细胞生长因子-23(FGF-23)、全段甲状旁腺激素(i PTH)水平及心肺功能的影响。方法选取在我院实施血液透析治疗的78例尿毒症患者,采用随机数字表法分为常规组和研究组各39例,收治时间2015年1月-2016年12月,常规组应用常规血液透析治疗,研究组采用HFHD方法治疗,均每周透析3次,2个月后实施效果对比。结果治疗前,常规组和研究组的肺功能指标VC、FVC、TLC及RV差异无统计学意义(P>0.05);治疗后,研究组的VC、FVC、TLC显著高于常规组(P<0.05),研究组的RV显著的低于常规组(P<0.05);治疗前,常规组和研究组的血清FGF-23、iPTH水平差异无统计学意义(P>0.05);治疗后,研究组的血清FGF-23、iPTH水平显著的低于常规组(P<0.05);治疗前,常规组和研究组的BNP、LVEF、LVEDd、LVESD、E/A差异无统计学意义(P>0.05);治疗后,研究组的BNP、LVEDd、LVESD显著的低于常规组(P<0.05),研究组的LVEF值显著的高于常规组(P<0.05)。结论 HFHD有利于改善尿毒症患者肺功能、心功能,同时降低血清FGF-23、i PTH的水平。

Objective To investigate the effects of high-flux hemodialysis（HFHD） on serum fibroblast growth factor-23（FGF-23）,parathyroid hormone（iPTH） levels and cardiopulmonary function in uremic patients. Methods Seventy-eight patients with uremia who underwent hemodialysis in First Affiliated Hospital of Xinxiang Medical College were randomly divided into control group and study group with 39 cases in each group from January 2015 to December 2016. The routine group were treated with conventional hemodialysis treatment and study group treated with HFHD,3 times each week dialysis. After 2 months,the effect was compared.Results Before the treatment,there were no significant differences in pulmonary function indexes VC,FVC,TLC and RV between the conventional group and the study group（P〈0.05）;after treatment,the VC,FVC and TLC of the study group were significantly higher than the conventional group（P〈0.05）,the RV of the study group was significantly lower than that of the conventional group（P〈0.05）;There was no significant difference in serum FGF-23 and iPTH levels between the conventional group and the study group before treatment（P〈0.05）;after treatment,the serum FGF-23,iPTH levels of the study group were significantly lower than that of conventional group（P〈0.05）;there was no significant difference in BNP,LVEF,LVEDd,LVESD and E/A between the conventional group and the study group before treatment（P〈0.05）;after treatment,the study group of BNP,LVEDd and LVESD were significantly lower than that of conventional group（P〈0.05）,the study group LVEF values significantly higher than the conventional group（P〈0.05）. Conclusion HFHD is beneficial to improve lung function and cardiac function in uremic patients,and to reduce serum FGF-23 and iPTH levels.