摘要
目的了解维持性血液透析患者的血管钙化情况,探讨其危险因素。方法收集90例维持性血液透析患者的临床资料,拍摄骨盆、双手X线片,计算血管钙化评分,测量血压水平,检测钙、磷等血生化指标和全段甲状旁腺素(iPTH)水平,多元Logistic回归分析血管钙化的危险因素。结果 90例维持性血液透析患者中60例(66.7%)存在不同程度的血管钙化,38例(42.2%)存在中重度钙化。60岁以上、男性、糖尿病、最长透析间期24h尿量<200ml患者发生中重度钙化的危险分别是<60岁、女性、非糖尿病、24h尿量≥200ml患者的2.80、2.62、4.68、3.00倍。中重度钙化患者的每日服用钙剂剂量、校正血钙、钙磷乘积水平较高,P<0.05。以血管钙化评分为因变量,多元Logistic回归分析结果显示,高水平的钙磷乘积、碱性磷酸酶与血管钙化的发生呈正相关,透析频率与血管钙化呈负相关。结论维持性血液透析患者普遍存在血管钙化,老龄、男性、糖尿病、残余肾功能丧失、钙磷乘积、碱性磷酸酶、透析频率低是血管钙化的相对危险因素。
Objective To investigate the status of vascular calcification in maintenance hemodialysis patients, and explore risk factors. Methods Vascular calcification was evaluated by plain radiographic films of pelvis and hands. Demographic and clinical data were collected. The parameters relating to vascular calcification were then analyzed by binary Logistic regression analysis. Results Among 90 cases of hemodialysis patients, 60 cases （66.7%） were developed vascular calcification in different degrees, 38 cases （42.2%） were found moderate or severe vascular calcification. Compared with patients younger than 60 years, female, non - diabetics, the urine volume more than 200ml/24h, moderate or severe vascular calcification occurred more often in patients aged over 60, male, diabetics, the urine volume less than 200ml/24h, and the OR value were 2.80,2.62,4.68,3.00 respectively. Patients with moderate or severe vascular calcification had a higher level of daily doses of calcium, adjustment serum calcium and the calcium - phosphorus product, P 〈 0.05. Binary logistic regression analysis showed that higher levels of calcium - phosphorus product, alkaline phosphatase were positively correlated with vascular calcification,and dialysis frequence was negatively correlated with vascular calcification. Conclusion Vascular calcification is commonly occurred in maintenance hemodialysis patients. Age, male, diabetes, calcium - phosphorus product, alkaline phosphatase, residual renal function were risk factors for vascular calcification.
出处
《医学研究杂志》
2012年第4期95-98,共4页
Journal of Medical Research
基金
温州市科技计划资助项目(Y20100224)
关键词
血液透析
血管钙化
危险因素
Hemodialysis
Vascular calcification
Risk factors
