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目的探讨不同血液净化方式对维持性血液透析(MHD)患者成纤维细胞生长因子-23(FGF-23)的清除效果。方法选取MHD患者120例为研究对象,随机分为低通量透析组(HD)、血液透析滤过组(HDF)、高通量透析组(HFHD),每组40例,治疗6个月,分别检测治疗前后血钙(Ca)、血磷(P)、碱性磷酸酶(ALP)、甲状旁腺素(PTH)、FGF-23水平的变化。结果 (1)三组患者治疗前后血Ca水平差异均无统计学意义(P>0.05);(2)HD组治疗前后血P、ALP、PTH、FGF-23水平差异均无统计学意义(P>0.05),HDF组和HFHD组治疗后血P、ALP、PTH、FGF-23水平与治疗前相比均明显下降(P<0.05),与HDF组相比,HFHD组PTH和FGF-23水平下降更明显(P<0.05)。结论与HD及HDF相比,HFHD能更有效清除FGF-23,降低MHD患者肾性骨病发生率。
Objective To investigate the clearance effect of different blood purification methods on fibroblast growth factor-23 (FGF-23) in maintenance hemodialysis (MHD) patients. Methods A total of 120 patients with MHD were enrolled in this study. They were randomly divided into low-dose dialysis group (HD), hemodiafiltration group (HDF) and high-dose dialysis group (HFHD) The levels of serum Ca, P, ALP, PTH and FGF-23 were measured before and after treatment. Results (1) There was no significant difference in blood Ca levels between the three groups before and after treatment (P> 0.05). (2) There was no significant difference in the levels of P, ALP, PTH and FGF- > 0.05). The levels of P, ALP, PTH and FGF-23 in HDF group and HFHD group were significantly lower than those before treatment (P <0.05). Compared with HDF group, the levels of PTH and FGF-23 Decreased more significantly (P <0.05). Conclusion Compared with HD and HDF, HFHD can effectively remove FGF-23 and reduce the incidence of renal osteodystrophy in patients with MHD.