维持性血液透析患者钙磷代谢异常调查  

Abnormal calcium and phosphorus metabolism in patients with maintenance hemodialysis

作　　者：王伟[1] 方静[1] 董俊邑 梁江红[1] 郁昊[1] 卢小琼 

机构地区：[1]成都铁路分局医院肾内科,四川成都610081

出　　处：《实用医院临床杂志》2010年第2期75-78,共4页Practical Journal of Clinical Medicine

摘　　要：目的通过对血液透析患者钙磷代谢的横断面调查,评价钙磷代谢紊乱的危险因素,为临床治疗提供依据。方法对2009年1月在成都铁路分局医院血液透析部接受维持性血液透析治疗的149例患者的临床资料进行横断面研究,调查患者年龄、原发病、透析龄及生物化学资料,并对上述指标进行统计学分析。结果149例患者血清钙水平(2.04±0.36)mmol/L,达标率43%;血清磷水平(1.93±0.65)mmol/L,达标率39%;甲状旁腺激素(PTH)水平(381±423)pg/ml,达标率38%;钙磷乘积达标者占58%,两者均达标者占13%;老年和糖尿病患者有较低的PTH、白蛋白水平,更短的透析时间;多元逐步回归分析显示In(PTH)与年龄、血清尿素氮(BUN)、尿素下降率(URR)、血浆白蛋白(ALB)、Ca2+、P3-等有关。结论维持性血液透析患者存在严重的钙磷代谢异常,老年和糖尿病患者容易合并低转运骨病。In(PTH)与年龄、BUN、URR.、ALB、Ca2+、P3-等有关。Objective To evaluate the risk factors of abnormal calcium and phosphorus metabolism in patients with maintenance hemodialysis by cross-sectional study,so as to provide evidence for clinical therapy.Methods Cross-sectional study was carried out in 149 patients with maintenance hemodialysis treated in Chengdu Railway Branch Hospital,1st,2009.The patients＇ age,primary diseases,time of dialysis and biochemistry data were statistically analyzed.Results The serum calcium level of the 149 patients （43 percent up to the standard） was 2.04±0.36 mmol/L.The serum phosphorus level of them （39 percent up to the standard） was（1.93±0.0.65）mmol/L.The parathyroid hormone （PTH） level of them （38 percent up to the standard） was（381±423）pg/ml.Of the 149 patients,86 reached the standard of calcium-phosphorus product,and 19 reached the standard of both calcium level and phosphorus level.Elderly patients and diabetes patients had lower PTH level and albumin level as well as shorter time dialysis.Multiple gradual regressive analysis showed that the In （PTH） level was related to age,BUN,URR,ALB,Ca^2＋ and P^3-.Conclusions There is serious abnormal calcium and phosphorus metabolism in the patients with maintenance hemodialysis.It is easy for elderly patients and diabetes patients with maintenance hemodialysis to get low-transport osteopathy.The level of the In （PTH） is related to age,BUN,URR,ALB,Ca^2＋ and P^3-.

关 键 词：血液透析 钙磷代谢 糖尿病 老年 

分 类 号：R692.5[医药卫生—泌尿科学] R459.5[医药卫生—外科学]