摘要目的:观察血液净化联合重组促红细胞生成素(EPO)治疗对尿毒症患者骨代谢水平的影响。方法:选择2018年1月至2019年12月本院收治的60例尿毒症患者病理资料，随机将其分为观察组(30例)与对照组(30例)，对照组患者采用血液净化治疗，观察组患者采用血液净化联合重组EPO治疗。比较两组患者治疗前后骨代谢指标变化情况、肾功能改善情况以及总有效率。结果:两组患者治疗前骨代谢指标比较，差异无统计学意义( P>0.05)，治疗后观察组患者血清全段甲状旁腺素(iPTH)、骨碱性磷酸酶(BALP)、血钙、血磷指标分别为(120.83±13.26)μg/mL、(10.03±1.84)IU/L、(1.89±0.33)mmol/L、(1.32±0.46)mmol/L，均低于对照组，差异有统计学意义( P<0.05)；观察组患者治疗后血尿素氮(BUN)、肌酐(Cr)水平分别为(10.58±2.56)mmol/L、(255.39±84.25)μmol/L，均低于对照组的(16.48±4.26)mmol/L、(364.15±67.24)μmol/L，差异有统计学意义( P<0.05)，两组治疗前肾功能水平比较，差异无统计学意义( P>0.05)；观察组患者治疗总有效率为93.3%(28/30)，高于对照组的70.0%(21/30)，差异有统计学意义( P<0.05)。 结论:血液净化联合重组EPO治疗尿毒症，对患者骨代谢指标改善作用显著，有利于降低肾损伤，疗效可靠，可予以推广。

abstractsObjective:To observe the effect of blood purification combined with recombinant erythropoietin(EPO) on bone metabolism in patients with uremia.Methods:The pathological data of 60 cases of uremia patients admitted to our hospital from January 2018 to December 2019 were retrospectively analyzed.According to the random number table method, they were divided into observation group(30 cases) and control group(30 cases). The control group was treated with blood purification, while the observation group was treated with blood purification and EPO. Changes of bone metabolism index, improvement of renal function and total effective rate before and after treatment were compared between the two groups.Results:There was no statistically significant difference in bone metabolism indexes between the two groups before treatment( P>0.05). After treatment, the indexes of iPTH, BALP, Ca and P in the observation group were(120.83±13.26) μg/mL, (10.03±1.84)IU/L, (1.89±0.33)mmol/L and(1.32±0.46)mmol/L, respectively, which were all lower than those in the control group( P<0.05). After treatment, the BUN and Cr levels in the observation group were(10.58±2.56)mmol/L and (255.39±84.25) μmol/L, respectively, lower than those in the control group(16.48±4.26)mmol/L and(364.15±67.24) mmol/L, with statistically significant differences( P<0.05). The total effective rate was 93.3%(28/30) in the observation group, which was higher than 70.0%(21/30) in the control group( P<0.05). Conclusions:The combination of blood purification and recombinant EPO in the treatment of uremia has a significant effect on the improvement of bone metabolism index in patients, and is conducive to the reduction of renal injury.