摘要
目的观察高通量血液透析联合维生素D3对尿毒症患者的疗效,及其对血清瘦素(Leptin)、颗粒蛋白前体(PGRN)和成纤维细胞生长因子-23(FGF-23)水平的影响。方法选择2015年1月至2016年12月行透析治疗的尿毒症患者84例,按照随机数字法分为观察组和对照组,每组42例。对照组予以高通量血液透析,观察组在对照组的基础上予以维生素D3治疗。观察2组治疗后的皮肤瘙痒缓解率,治疗前后血清钙、磷、PTH、血管钙化评分、生活质量、Leptin、PGRN和FGF-23水平的变化。结果观察组皮肤瘙痒总缓解率为76. 19%,明显优于对照组的52. 38%(X^2=4. 200,P <0. 05)。观察组的疲劳程度、抑郁表现、挫折感、人际关系和总分明显高于对照组(P <0. 05),而2组的体征评分差异无统计学意义(P> 0. 05)。2组治疗前血清钙、磷、PTH、血管钙化评分、Leptin、PGRN和FGF-23差异无统计学意义(P> 0. 05),治疗后2组较治疗前明显降低(P <0. 01);观察组的血清磷、PTH、血管钙化评分、Leptin、PGRN和FGF-23降低水平较对照组更为明显(P <0. 01),而观察组的血清钙水平与对照组比较差异无统计学意义(P> 0. 05)。结论高通量血液透析联合维生素D3对尿毒症患者的疗效显著,具有明显提高患者生存质量,其机制可能与机体的微炎症改善有关。
Objective To observe the therapeutic effect of high-flux hemodialysis combined with vitamin D3 in uremic patients and their impacts on serum levels of Leptin, granule protein precursor (PGRN) and fibroblast growth factor 23 (FGF 23). MethodsEighty-four patients with uremia who underwent dialysis in our hospital from January 2015 to December 2016 were enrolled in the study. The patients were divided into observation group ( n =42) and control group ( n =42) according to random number table method. The patients in control group were treated by high-flux hemodialysis, and those in observation group, on the basis of control group, were treated by vitamin D3. The remission rate of skin pruritus after treatment was observed in both groups. The changes of serum calcium, phosphorus, PTH, vascular calcification (VC) score, quality of life, Leptin, PGRN and FGF-23 before and after treatment were recorded. ResultsThe remission rate of skin pruritus in the observation group was 76.19%,, which was significantly higher than that (52.38%) in the control group (χ 2=4.200, P <0.05). The fatigue score, depression performance, frustration, interpersonal relationship and total score of the observation group were significantly higher than those of the control group ( P <0.05), but there was no significant difference in the scores of signs in the two groups ( P >0.05). No significant differences were observed in serum calcium, phosphorus, PTH, VC score, Leptin, PGRN and FGF 23 between the two groups before treatment ( P >0.05). After treatment, those indicators in the two groups were significantly lower than those before treatment ( P <0.01). Specifically, the serum levels of serum phosphorus, PTH, VC score, Leptin, PGRN and FGF 23 were significantly lower than those of the control group ( P <0.01), while no significant differences were found in the serum calcium level of the observation group, as compared with the control group ( P >0.05). ConclusionHigh-flux hemodialysis combined with vitamin D3 has a remarkable effect on patients
作者
陆玉兰
周毅
王燕
张哲
LU Yulan;ZHOU Yi;WANG Yan(Department of Pharmacy,Central Hospital of Fengxian District,Shanghai 201499,China)
出处
《河北医药》
CAS
2019年第1期71-74,共4页
Hebei Medical Journal
