【摘要】 目的探讨不同透析方式对终末期糖尿病肾病(DKD)患者血清Klotho蛋白、血清成纤维细胞生长因子23(FGF-23)及颈动脉内膜中层厚度(IMT)的影响。方法选择终末期DKD患者80例,按随机数字表法分为血液透析(HD)组及腹膜透析(PD)组,每组各40例。所有患者透析后0、6、12个月均测定血清Klotho、FGF-23及颈动脉IMT水平。结果透析治疗后,血清Klotho均呈持续上升趋势,但两组同期对比差异均无统计学意义;FGF-23水平均呈持续下降趋势,但两组同期对比,治疗12个月时,PD组<HD组(P<0.05);颈动脉IMT在治疗12个月时均明显升高(P<0.05),但两组同期对比差异均无统计学意义。结论 HD和PD对透析12个月内颈动脉IMT的影响无明显差异。两种透析方式均能提高终末期DKD患者的血清Klotho蛋白,降低FGF-23,但PD相较于HD,在相对远期降低FGF-23方面更有优势。更多还原

【Abstract】 Objective To investigate the effects of different dialysis methods on serum Klotho protein, serum fibroblasts growth factor-23（FGF-23） and carotid intima-media thickness（IMT） in patients with end-stage diabetic kidney disease（DKD）. Methods A total of 80 patients with end-stage DKD, which were hospitalized in Department of Nephrology, were randomly divided into hemodialysis（HD） group（n=40） and peritoneal dialysis（PD） group（n=40）. The levels of serum Klotho protein, FGF-23 and carotid IMT were measured in all patients 0, 6 and 12 months after dialysis. Results After dialysis treatment, the serum Klotho protein showed a continuous upward trend, but there was no statistically significant difference between HD group and PD group in the same period. The FGF-23 level showed a continuous downward trend, but there was no statistically significant difference between the HD group and the PD group at 6^th month, but it was significantly lower in the PD group significantly than the HD group at the 12^th months（P<0.05）. Carotid IMT was significantly increased at the 12^th months of treatment（P<0.05）, but there was no significant difference between the HD group and the PD group. Conclusion There was no significant difference between HD and PD on carotid IMT within 12 months of dialysis. HD and PD could increase serum Klotho protein and reduce FGF-23 in patients with end-stage DKD. However, compared with hemodialysis, peritoneal dialysis has more advantages in reducing FGF-23 in a relatively long-term.更多还原