摘要
目的 探讨尿毒清颗粒联合复方α酮酸治疗慢性肾脏病-矿质与骨性症候群（CKD-MBD）的疗效及对患者血清Ⅰ型胶原氨基端前肽（N-terminal propeptideof type Ⅰ procollage,PINP）和Ⅰ型胶原羧基端肽β特殊序列（β-crosslaps,β-CTX）及成纤维生长因子23（fibroblast growth factor 23,FGF23）表达的影响.方法 选择2012年1月～ 2014年6月期间40例在武汉市华中科技大学同济医学院附属普爱医院诊断为CKD5期并CKD-MBD的患者为研究对象,按照随机数字表法随机分为观察组和对照组,每组各20例.对照组给予常规治疗;观察组在对照组基础上给予尿毒清颗粒联合复方α酮酸治疗.统计2组疗效及治疗前后钙（Ca）、磷（P）、HNP、β-CTX、FGF23水平.结果 随着病情的加重,血清PINP水平呈下降趋势,FGF23水平呈上升趋势,CKD-MBD组,CKD4期组,CKD3期组的PINP,FGF23水平与对照组比较差异均有统计学意义（P＜0.01）,2组血清β-CTX水平差异无统计学意义;观察组有效率（90.0％）高于对照组（60.0％）,差异有统计学意义（P＜0.05）;与对照组治疗前比较,治疗后Ca、PINP水平均升高,FGF23水平降低,差异有统计学意义（P＜0.05）;与观察组治疗前比较,P、FGF23水平降低,PINP水平升高,差异有统计学意义（P＜0.05）;与对照组治疗后比较,观察组P、FGF23水平降低,PINP水平均升高,差异有统计学意义（P＜0.05）;治疗前和治疗后,血P、FGF23的表达之间呈正相关（r =0.397;r=0.402;P＜ 0.05）,血P、FGF23的表达与血Ca的表达均呈负相关（t=-0.402,-0.392;r=-0.397,-0.395;P ＜0.05）,血PINP、β-CTX表达之间呈正相关（r=0.298;r =0.315;P＜0.05）,血PINP、β-CTX表达与血Ca的表达均呈正相关（r=0.318,0.298;r =0.315,0.302;P＜0.05）.结论 尿毒清颗粒联合复方α酮酸可提高CKD-MBD患者血中Ca、PINP、β-CTX的水平,降低血P、FGF23的表达,进而改善CKD-MBD患者临床症状,有效延缓患者病情进展.
Objective To study effect of Niaoduqing combined with compound α keto acid on PINP,β-CTX and FGF23 in patients with CKDMBD. Methods Between January 2012 and June 2014,40 patients with CKD-MBD were selected as the research objects. 40 patients with uremia according to random number table method were divided into observation group and control group（ n = 20,respectively）. Control group were given conventional treatment,and observation group were given Niaoduqing combined with compound α keto acid treatment on the basis of the control group. The curative effect and calcium（ Ca）,phosphorus（ P）,PINP,β-CTX,FGF23 levels between two groups were observed before and after treatment. Results As the illness aggravating,PINP levels showed a downward trend,and the serum levels of FGF23 levels were on the rise,compared with control group,the serum level of PINP,FGF23 among CKD-MBD,CKD-3 and CKD-4 group,the difference was statistically significant（ P〈 0. 01）,but the serum level of β-CTX had no statistically significant. The observation group＇s efficiency（ 90. 0%） were higher than that of control group（ 60. 0%）,and the difference was statistically significant（ P〈 0. 05）; compared with the control group before treatment,levels of Ca,PINP increased after treatment,the level of FGF23 decreased,the difference was statistically significant（ P〈 0. 05）,and compared with observation group before treatment,levels of P,FGF23 decreased and PINP level increased,the difference was statistically significant（ P〈 0. 05）; and compared with control group after treatment,the level of P,FGF23 reduced in observation group,PINP levels increased,the difference was statistically significant（ P〈 0. 05）; Before and after treatment,the expression of P positively correlated with FGF23（ r = 0. 397; r = 0. 402; P〈 0. 05）,the expression of P and FGF23 negatively correlated with the expression of Ca（ r =- 0. 402,- 0. 392; r =- 0. 397,- 0. 395; P〈 0. 05）,and blood PINP positively correlated with
出处
《中国生化药物杂志》
CAS
2015年第2期100-103,共4页
Chinese Journal of Biochemical Pharmaceutics
