摘要
目的了解维持性血液透析(MHD)患者钙磷代谢情况及血清全段甲状旁腺素(iPTH)水平以评估矿物质与骨代谢紊乱(MBD)情况,并进行相关影响因素分析。方法采用横断面研究方法调查南华大学附属第二医院血液净化中心116例MHD患者矿物质与骨代谢指标达标情况,并分析其与年龄、性别、透析时间、体重指数(BMI)、血红蛋白(Hb)、肾功能、碱性磷酸酶(ALP)、高血压、糖尿病之间的相关性。结果 116例患者中,54例(46.55%)血清钙浓度、37例(31.90%)血磷浓度、71例(61.20%)钙磷乘积和36例(31.03%)iPTH达到指南要求;上述指标均达标者仅有19例(16.38%)。MBD与肾功能、Hb、BMI、高血压相关,与年龄、性别、透析时间不相关。高ALP与高水平iPTH相关,高血糖与低水平iPTH相关。结论多数MHD患者存在MBD,其发生与肾功能、血红蛋白水平、BMI、有无高血压密切相关。此外,升高的骨ALP与高iPTH可联合预测肾性骨病的类型。高血糖可能是MBD的易感因素。
Objective To understand the controlling situation of mineral and bone disorder（MBD） in maintenance hemodialysis patients,and analyze their related factors.Methods We investigated MBD in 116 maintenance hemodialysis patients in Hemodialysis Center of the Second Affiliated Hospital of NanHua University,and compared these data with the guidelines.We also analyzed age,gender,years for dialysis,body mass index（BMI）,Hb,renal function,alkaline phosphatase（ALP）,blood pressure,and diabetes mellitus in these patients.Results In the 116 cases,54（46.55%） cases of serum Ca,37（31.9%）cases of phosphate,71（61.20%）cases Ca×P product and 36（31.03%）cases of iPTH meet the requirements of the guidelines.However,normal values of the above 4 parameters recommended by KDIGO were only found in 19（16.38%）cases.Single variable regression analyses showed that MBD did not correlate with gender,age,and years for dialysis.However,worse renal function,lower Hb,lower BMI,and blood pressure were correlate with mineral and bone disorder.In addition,Higher level of ALP was correlate with higher iPTH level.But diabetic hemodialysis patients in lower iPTH-level group were more than other groups.Conclusion The control of the MBD could not conform to the standards in the KDIGO guidelines in most hemodialytic patients.The presence of MBD was associated with worse renal function,lower Hb and hypertension.Simultaneous measurement of serum iPTH and ALP levels may be the reliable tool to predict the type of MBD.High blood sugar level might be risk factor of MBD.
出处
《中南医学科学杂志》
CAS
2013年第3期267-269,272,共4页
Medical Science Journal of Central South China
