不同血液净化方式对尿毒症患者动脉钙化的影响-肾脏内科专业论文.docxVIP

重庆 重庆医科大学硕士研究生学位论文 万方数据 万方数据 英汉缩略语名词对照 英文缩写 英文名称 中文名称 ESRD End-stage renal disease 终末期肾病 CKD Chronic kidney disease 慢性肾脏病 HDF Hemodiafiltration 血液透析滤过 HD Hemodialysis 血液透析 PTH Parathormone 甲状旁腺激素 CRP C-reaction protein C 反应蛋白 FGF-23 Human fibroblast growth factor-23 人成纤维细胞生长因子 -23 Cbfa-1 Core binding factor α-1 细胞核结合因子α-1 OPG Osteoprotegrin 骨保护素 RANK Receptor activator of nuclear factor kappa B RANKL Receptor activator of nuclear factor kappa B ligand 细胞核因子κB 受体 活化因子 细胞核因子κB 受体 活化因子配基 TNF-α tumor necrosis factor-α 肿瘤坏死因子-α TGF-β transforming growth factor-β 转化生长因子-β 1 不同血液净化方式对尿毒症患者动脉钙化的影响 摘要 目的：探讨不同血液净化方式对尿毒症患者动脉钙化程度的影响。 方法：选取我院长期进行血液净化治疗的尿毒症患者 97 例，按血 液净化方式不同分为血液透析滤过（HDF）组、血液透析（HD）组， 利用多层螺旋 CT 进行全腹扫描，评价腹主动脉及髂动脉钙化程度，分 析不同血液净化方式对患者血管钙化分级的影响。结果 HDF 组和 HD 组患者动脉不同程度血管钙化分别为 42 例（72.4%）和 37 例（94.9%）， 两组血管钙化程度分级比较差异有统计学意义（P＜0.05），HDF、HD 组原发疾病构成、年龄、透析龄、透析前血压比较差异无统计学意义， HDF 组甲状旁腺激素（PTH）低于 HD 组（P＜0.05），HDF 组 C 反应 蛋白（CRP）低于 HD 组（P＜0.05），HDF 组血红蛋白高于 HD 组（P ＜0.01），差异有统计学意义。 结论：尿毒症患者动脉钙化发生率高，血液透析滤过治疗的患者 血管钙化程度轻。 关键词 血液透析，血液透析滤过，动脉钙化 2 THE INFLUENCE OF DIFFERENT BLOOD PURIFICATION METHODS ON ARTERY CALCIFICATION IN UREMIC PATIENTS ABSTRACT Objective: To evaluate the influence of different blood purification methods on the degree of artery calcification in uremic patients. Methods: 97 patients received long-term blood purification therapy in our hospital were investigated and divided into 2 groups according to the purification way : hemodiafiltration group(HDF,n=58) and hemodialysis group(HD,n=39). Multi-slice CT for full abdomen scan was used to evaluate the calcification degree of abdominal aorta and iliac artery.Combined with general clinical data, the influences of different blood purification on the degree of artery calcification were analyzed. Results: Varying degrees of artery calcification were observed in 42 cases of HDF group(72.4%) and 37 cases of HD group(94.9%).Differences of artery calcification grade between two groups were statistically significant(P0.05). Diffe