本文關(guān)鍵詞： 腎透析 夜間透析 成纖維細(xì)胞生長因子 慢性腎臟病-礦物質(zhì)和骨異常　出處：《第二軍醫(yī)大學(xué)學(xué)報(bào)》2017年01期 　論文類型：期刊論文

【摘要】：目的比較中心夜間血液透析(INHD)和傳統(tǒng)血液透析(CHD)患者循環(huán)成纖維細(xì)胞生長因子23(FGF23)水平差異并探討影響患者FGF23水平的因素。方法收集第二軍醫(yī)大學(xué)長征醫(yī)院44例INHD及64例CHD患者空腹靜脈血,測(cè)定患者鈣、磷、全段甲狀旁腺素(iPTH)、尿素清除指數(shù)(Kt/V)、25-羥維生素D、鐵蛋白、血紅蛋白、血脂、FGF23等指標(biāo)并比較兩組各指標(biāo)的差異,采用多重線性回歸分析探究FGF23的影響因素,Pearson相關(guān)性分析探究FGF23與血鈣、血磷、鈣磷乘積、iPTH、25-羥維生素D、Kt/V的相關(guān)性。結(jié)果 INHD患者血磷較CHD患者低(P0.05),INHD透析充分性明顯高于CHD,INHD患者循環(huán)FGF23水平低于CHD患者(P0.05)。FGF23與鈣、磷、鈣磷乘積相關(guān)(P0.01),與iPTH及Kt/V不相關(guān)。結(jié)論 INHD比CHD更能有效改善慢性腎臟病-礦物質(zhì)和骨異常(CKD-MBD)參數(shù)。鈣磷乘積是血液透析患者FGF23水平的獨(dú)立影響因素,INHD通過減少鈣磷乘積降低血清FGF23水平可能是其改善患者臨床預(yù)后的機(jī)制之一。
[Abstract]:Objective to compare the difference of circulating fibroblast growth factor 23 FGF23 between patients with central and traditional hemodialysis (HD) and to explore the factors influencing the level of FGF23. Methods 44 cases of INHD in long March Hospital of second military Medical University were collected. And 64 patients with CHD, Calcium, phosphorus, total parathyroid hormone (PTH), urea clearance index (KT / V), 25-hydroxyvitamin D, ferritin, hemoglobin, blood lipid and FGF23 were measured and compared between the two groups. Multiple linear regression analysis was used to explore the influencing factors of FGF23. Pearson correlation analysis was used to explore the relationship between FGF23 and serum calcium and phosphorus. Results compared with the patients with CHD, the adequacy of blood phosphorus in INHD patients was significantly higher than that in patients with CHD. The level of circulating FGF23 in patients with INHD was lower than that in patients with CHD. FGF23 and Ca, P, P, P, P, P, P, P, P, P, P, P, P, P, P, P, P, P, P, P, P, P, P, P, P and P. Conclusion INHD is more effective than CHD in improving CKD-MBD parameters of chronic kidney disease, mineral and bone abnormalities. Calcium and phosphorus product is an independent influencing factor of FGF23 level in hemodialysis patients. The reduction of serum FGF23 level by calcium-phosphorus product may be one of the mechanisms to improve the clinical prognosis of patients.
【作者單位】： 第二軍醫(yī)大學(xué)長征醫(yī)院腎內(nèi)科解放軍腎臟病研究所;第二軍醫(yī)大學(xué)衛(wèi)生勤務(wù)學(xué)系衛(wèi)生統(tǒng)計(jì)學(xué)教研室;
【基金】：國家自然科學(xué)基金(81370844)~~
【分類號(hào)】：R692.5
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本文編號(hào)：1498157