活性维生素D_(3)对维持性血液透析患者钙磷代谢、衰弱和疲乏状态的影响

Effects of Active Vitamin D_(3)on Calcium-phosphorus Metabolism,Frailty and Fatigue in Patients Undergoing Maintenance Hemodialysis

目的:探究活性维生素D_(3)对维持性血液透析(MHD)患者的钙磷代谢、衰弱和疲乏状态的影响。方法:选取2021年3月—2023年3月景德镇市第三人民医院收治的82例MHD患者作为研究对象,随机分成对照组和观察组,各41例。对照组给予基础治疗,观察组在对照组的基础上加用活性维生素D_(3)治疗,治疗期3个月。观察两组治疗前后血清磷(P)、钙(Ca)、炎症因子[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、心功能指标[左心室质量(LVM)、左心室质量指数(LVMI)]、Tilburg衰弱指数(TFI)和疲劳量表(FS-14)评分。结果:治疗后,观察组血清Ca水平高于对照组,血清P、hs-CRP、IL-6、TNF-α、LVM和LVMI水平均低于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组TFI评分、FS-14评分均低于对照组,差异均有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:活性维生素D_(3)用于MHD患者可有效改善钙磷代谢,改善微炎症状态,逆转左心室肥厚,缓解机体的衰弱和疲乏的症状。

Objective:To investigate the effects of active vitamin D_(3)on calcium-phosphorus metabolism,frailty and fatigue in maintenance hemodialysis(MHD)patients.Method:A total of 82 MHD patients admitted to Jingdezhen Third People's Hospital from March 2021 to March 2023 were selected as the study objects and randomly divided into control group and observation group,with 41 cases in each group.The control group was given basic treatment,and the observation group was treated with active vitamin D_(3)on the basis of the control group.The treatment period was 3 months.Serum phosphorus(P),calcium(Ca),inflammatory factors[hypersensitiveC reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],cardiac function indexes[left ventricular mass(LVM),left ventricular mass index(LVMI)]and Tilburg frailty index(TFI)and fatigue scale-14(FS-14)score before and after treatment between the two groups were observed.Result:After treatment,the serum Ca level of observation group was higher than that of control group,and the serum P,hs-CRP,IL-6,TNF-α,LVM and LVMI levels were lower than those of control group,the differences were statistically significant(P<0.05).After treatment,the TFI score and FS-14 score of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Active vitamin D_(3)can effectively improve calcium-phosphorus metabolism and micro-inflammatory state,reverse left ventricular hypertrophy,relieve frailty and fatigue in MHD patients.