幽门螺杆菌感染对维持性血液透析患者矿物质和骨代谢相关指标的影响

Influence of Helicobacter pylori infection on minerals and bone metabolism-related indexes of patients undergoing maintenance hemodialysis

目的探讨幽门螺杆菌(Hp)感染对维持性血液透析(MHD)患者矿物质及骨代谢指标的影响。方法选取2017年8月-2020年8月天津市第五中心医院收治的MHD患者101例,收集患者的临床资料,分析患者Hp感染情况,采集血液标本检测矿物质代谢指标血钙(Ca)、血磷(P)及骨代谢相关指标β-胶原降解产物(β-CTX)、N端骨钙素(N-MID)、总I型胶原氨基端延肽(TPINP)、全段甲状旁腺素(iPTH)、25羟维生素D(25(OH)D)和人成纤维细胞生长因子23(FGF-23)。结果101例MHD患者,检出Hp阳性36例,Hp感染率为35.64%。Hp感染组患者性别、年龄、透析龄、原发病类型及体质量指数与Hp未感染组比较差异无统计学意义。Hp感染组患者矿物质代谢指标血清Ca、P水平分别为(2.25±0.24)、(2.02±0.38)mmol/L均高于Hp未感染组(P<0.05)。Hp感染组患者骨代谢相关指标除25(OH)D水平低于Hp未感染组,其他指标水平均高于Hp未感染组(P<0.05)。结论Hp感染与MHD患者的矿物质、骨转换标志物、骨代谢和FGF-23等指标表达水平相关,可能会增加MHD患者的矿物质、骨代谢紊乱的风险。

OBJECTIVE To explore the influence of Helicobacter pylori(Hp)infection on minerals and bone metabolism indexes of the patients undergoing maintenance hemodialysis(MHD).METHODS A total of 101MHD patients who were treated in Tianjin Fifth Central Hospital from Aug 2017to Aug 2020were enrolled in the study,the clinical data were collected,the prevalence of Hp infection was analyzed,and the blood specimens were collected to detect the minerals metabolism indexes blood calcium(Ca),blood phosphorus(P)and bone metabolism-related indexesβ-collagen degradation products(β-CTX),N-terminal osteocalcin(N-MID),total type I collagen amino terminal peptide(TPINP),full parathyroid hormone(iPTH),25-hydroxyvitamin D(25(OH)D)and human fibroblast growth factor 23(FGF-23).RESULTS Of the 101MHD patients,36were tested positive for Hp,with the Hp infection rate 35.64%.There were no significant differences in the genders,age,time of dialysis,types of primary disease and body mass index between the Hp infection group and the no Hp infection group.The levels of minerals metabolism indexes serum Ca and P of the Hp infection group were respectively(2.25±0.24)and(2.02±0.38)mmol/L,significantly higher than those of the no Hp infection group(P<0.05).The levels of all the bone metabolism indexes of the Hp infection group were significatly significantly higher than those of the no Hp infection group except for 25(OH)D(P<0.05).CONCLUSIONThe Hp infection is associated with the expression levels of minerals,bone turnover markers,bone metabolism and FGF-23of the MHD patients,which may increase the risk of disorders of minerals,bone metabolisms.