BMP联合PTH评估血液透析肾性骨病患者的疗效
Journal: Basic Medical Theory Research DOI: 10.12238/bmtr.v6i3.7486
Abstract
目的：探讨骨形态发生蛋白(BMP)联合甲状旁腺素(PTH)评估血液透析联合血液灌流对血液透析肾性骨病患者疗效的效能。方法：选取2019年1月至2022年6月本医院收治的160例血液透析肾性骨病患者为研究对象,所有患者均接受血液透析联合血液灌流治疗,根据患者临床治疗效果划分为治疗有效组(n=129)和治疗无效组(n=31)。收集并对比两组患者一般临床资料；血尿素氮(BUN)、血清肌酐(Scr)、β2微球蛋白(β2-MG)及尿酸(UA)的表达水平；血清BMP、PTH的表达水平。通过相关性分析及多因素Logistic回归分析筛选与血液透析肾性骨病患者治疗无效相关的危险因素。结果：治疗无效组患者治疗前平均BUN、Scr、β2-MG、UA水平显著高于治疗有效组患者(P<0.05)；治疗无效组患者治疗前平均BMP2、BMP3、BMP7、BMP9水平显著低于治疗有效组患者,血清PTH水平显著高于治疗有效组患者 (P<0.05)；Pearson相关性分析表明血液透析肾性骨性患者Scr与BMP7呈负相关性,与PTH呈正相关性(P<0.05)；Spearman相关性分析表明BMP2、BMP3、BMP7及BMP9与治疗无效呈负相关性,PTH与治疗无效呈正相关性(P<0.05)；多因素Logistic回归分析结果显示,BMP3、BMP7水平降低及PTH水平升高均是血液透析肾性骨病患者治疗无效的危险因素(P<0.05)。结论：BMP、PTH是接受血液透析联合血液灌流的肾性骨病患者治疗无效的影响因素,可作为未来监测患者病情发展、评价患者治疗效果的重要生物学标志物。
Keywords
血液透析；血液灌流；肾性骨病；骨形态发生蛋白；甲状旁腺素
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[3] 陈育青,Bernard Canaud.血液透析滤过的技术及应用现状[J].中国血液净化,2021,20(10):649-653.
[4] 伍子贤,戴如璋,林少豪.肾性骨病相关分子通路的研究进展[J].中国骨质疏松杂志,2020,26(01):146-151.
[5] Reichel H, Esser A, Roth HJ, et al. Influence of PTH ass ay methodology on differential diagnosis of renal bone disea se[J].Nephrol Dial Transplant.2003;18(4):759-768.
[6] 欧三桃,熊琳.肾性骨病的诊断现状与研究进展述评[J].西部医学,2022,34(02):157-160+167.
[7] Sprague SM.Renal bone disease[J].Curr Opin Endocrinol Diabetes Obes.2010,17(6):535-539.
[8] Bellorin-Font E, Rojas E, Martin KJ. Bone Disease in Chronic Kidney Disease and Kidney Transplant[J]. Nutrients. 2022;15(1):167.
[9] Imel EA. Enthesopathy, Osteoarthritis, and Mobility in X-linked Hypophosphatemia1[J].J Clin Endocrinol Metab. 2020; 105(7):dgaa242.
[10] 钱惠艳.慢性肾衰竭患者血液透析护理研究进展[J].透析与人工器官,2020,31(04):65-67+70.
[11] 吴卿霞,徐敏,沈培培.血液透析与血液灌流联合治疗老年维持性透析肾性骨病患者的疗效[J].中外医疗,2023,42(08):28-31.
[12] 杨洋.费森4008S血液透析机联合一次性血液灌流器治疗老年维持性透析合并肾性骨病的疗效观察[J].中国医疗器械信息,2022,28(22):24-26.
[13] Nakagawa Y,Komaba H,Hamano N,etal.Interrelationships Between Sclerostin, Secondary Hyperparathyroidism, and Bone Metabolism in Patients on Hemodialysis[J]. J Clin Endocrinol Metab.2022;107(1):e95-e105.
[14] Xie L,Hu X,Li W,etal.A retrospective study of end-st age kidney disease patients on maintenance hemodialysis with renal osteodystrophy-associated fragility fractures[J]. BMC Nephrol.2021;22(1):23.
[15] MengY,FuM,GuoJ,etal.Characteristicsandcomplicationsoffractureinolderadultswithchronickidneydisease:across-sectionalstudy[J].JOrthop Surg Res.2022;17(1):377.
[16] 伍晓辉,尤海岩,胡蓉.肾衰营养胶囊对肾性骨病大鼠骨代谢及股骨组织BMP-2表达的影响[J].天津医药,2020,48(02):91-95.
[17] Khan MP,Khan K,Yadav PS,et al. BMP signaling is requ ired for adult skeletal homeostasis and mediates bone anabolic action of parathyroid hormone[J].Bone.2016,92:132- 144.
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