1,25-(OH)_2D_3对维持性血液透析病人心血管源死亡率的影响  

Effect of 1,25-(OH)_2D_3 on cardiovascular mortality among the patients on the treatment of supporting haemodialysis

作　　者：钟波[1] 杨飞[1] 王宁[1] 翟静妤[1] 李莉[1] 朱艳[1] 

机构地区：[1]解放军306医院血液净化中心,北京市100101

出　　处：《实用医学杂志》2006年第3期286-289,共4页The Journal of Practical Medicine

摘　　要：目的:评估1,25-(O H)2D3对终末期肾脏疾病维持性血液透析病人心脏意外事件发生率的影响。方法:共随访62名维持性血液透析的终末期肾脏疾病病人,透析时间(96.8±39.1)周,按照是否规律使用1,25-(O H)2D3分为治疗组(n=40)和对照组(n=22),每日服用盖三醇的剂量范围为0.25～0.50μg,平均剂量为0.30μg,对照分析两组病例心血管源性意外和死亡的危险性。结果:对于存在心血管基础疾病的病例,规律使用1,25-(O H)2D3的治疗组较对照组心脏意外死亡的危险性显著降低(单变量C ox模型H R0.259,95%可信区间0.077～0.875,P=0.03),而对于无心血管系统基础病的病例,其心血管源死亡的危险性差异无显著性。结论:使用1,25-(O H)2D3能降低终末期肾脏疾病维持性血液透析病人心脏意外事件的发生率。bjective To evaluate the effect of 1, 25-（OH）2D3 on cardiovascular mortality among the patients with end-stage renal disease （ESRD） and on the treatment of supporting haemodialysis. Methods We compared the risk of death of cardiovascular system between regular users （ n=40） and non-users （ n=22） of oral 1,25-（OH）2D3 in a cohort of ESRD patients undergoing haemodialysis for a follow-up of （96. 8±39.1） weeks. The daily dose of 1, 25-（OH）2D3 was administered from 0. 25 to 0. 50 p.g, with a medium of 0. 3 μg. Results It demonstrated that the regular use of 1, 25-（OH）2 D3 can significantly reduce the risk of death from cardiovascular disease among the patients with ESRD univariate Cox model [hazard ratio （HR） 0. 259; 95% confidence interval （CI） 0. 077-0. 875; P=0. 03], whereas there was no difference on the risk of death between the regular and irregular users without cardiovascular disease. Conclusion The study indicates that the use of oral alfacalcidol can effectively lower the risk of death from cardiovascular disease among the patients with ESRD and on supporting haemodialysis and improve their long-term survival rate.

关 键 词：肾透析 活性维生素D3 心血管源死亡率 终末期肾脏疾病 血液透析病人 心血管系统 维持性 意外事件发生率 死亡率 持性血液透析 

分 类 号：R692.5[医药卫生—泌尿科学]