中心夜间透析和传统透析患者循环成纤维细胞生长因子23水平差异及影响因素
发布时间:2018-02-09 14:37
本文关键词: 肾透析 夜间透析 成纤维细胞生长因子 慢性肾脏病-矿物质和骨异常 出处:《第二军医大学学报》2017年01期 论文类型:期刊论文
【摘要】:目的比较中心夜间血液透析(INHD)和传统血液透析(CHD)患者循环成纤维细胞生长因子23(FGF23)水平差异并探讨影响患者FGF23水平的因素。方法收集第二军医大学长征医院44例INHD及64例CHD患者空腹静脉血,测定患者钙、磷、全段甲状旁腺素(iPTH)、尿素清除指数(Kt/V)、25-羟维生素D、铁蛋白、血红蛋白、血脂、FGF23等指标并比较两组各指标的差异,采用多重线性回归分析探究FGF23的影响因素,Pearson相关性分析探究FGF23与血钙、血磷、钙磷乘积、iPTH、25-羟维生素D、Kt/V的相关性。结果 INHD患者血磷较CHD患者低(P0.05),INHD透析充分性明显高于CHD,INHD患者循环FGF23水平低于CHD患者(P0.05)。FGF23与钙、磷、钙磷乘积相关(P0.01),与iPTH及Kt/V不相关。结论 INHD比CHD更能有效改善慢性肾脏病-矿物质和骨异常(CKD-MBD)参数。钙磷乘积是血液透析患者FGF23水平的独立影响因素,INHD通过减少钙磷乘积降低血清FGF23水平可能是其改善患者临床预后的机制之一。
[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.
【作者单位】: 第二军医大学长征医院肾内科解放军肾脏病研究所;第二军医大学卫生勤务学系卫生统计学教研室;
【基金】:国家自然科学基金(81370844)~~
【分类号】:R692.5
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本文编号:1498157
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