维持性血液透析患者血管钙化的发生情况及相关危险因素分析  

Occurrence of vascular calcification and the related risk factors in maintenance hemodialysis patients

作　　者：吴姝焜[1] 洪大情[1] 王芳[1] 王君如[1] 王政通[1] 张亚玲[1] 孟祥龙[1] 王莉[1] 

机构地区：[1]四川省医学科学院四川省人民医院肾内科,成都610072

出　　处：《临床肾脏病杂志》2013年第1期22-24,共3页Journal Of Clinical Nephrology

摘　　要：目的探讨维持性血液透析患者的血管钙化发生情况及相关危险因素分析。方法选择血液透析患者91例，记录相关人口学资料及临床资料，完善实验室检查。分别以X光片（腰椎侧位、双手、骨盆）评价血管钙化情况。结果91例患者中无血管钙化者22例，有不同程度血管钙化者69例；轻度钙化38例（占41．76％），中度钙化14例（占19．72％），重度钙化17例（占23．94％）；统计学分析显示2组间年龄、血磷和钙磷乘积有统计学差异（P〈0．05）；单因素分析显示年龄、血磷、钙磷乘积和未服用活性维生素D是血管钙化的危险因素，多因素分析显示年龄、血磷、未服用活性维生素D为血管钙化独立影响因素。结论血管钙化是维持性血液透析患者常见并发症，且发病率较高，高龄、高磷血症、高钙磷乘积及合理使用活性维生素D在钙化发生、发展中有重要作用。Objective To study the occurrence of vascular calcification and the related risk fac- tors in maintenance hemodialysis （MHD）. Methods Ninety MHD patients were enrolled. The data a- bout general information, serum calcium and phosphorous, and intact PTH （iPTH） were recorded. X-ray examinations of hands, pelvis and lateral lumbar spine were clone to evaluate vascular calcifica- tion. Results Of 91 MHD patients, vascular calcification with different degrees occurred in 69 cases, and the rest 22 patients had no vascular calcification. Of the 69 patients,mild vascular calcification oc- curred in 38 cases （41.76~）, moderate in 14 cases （19. 72%）, and severe in 17 cases （23. 94~）. There was significant difference in age, calcium-phosphate product and phosphorus between vascular calcification group and non-vascular calcification group. Logistic regression analysis revealed that age, calcium-phosphate product, phosphorus and non-vit D therapy were the risk factors of vascular calcifi- cation. The age, phosphorus and non-vit D therapy were the independent risk factors of vascular calcifi- cation. Conclusions Vascular calcification is a common complication of MHD patients and has high in- cidence. The age, calcium-phosphate product, phosphorus and legitimately vitamin D therapy can affect the vascular calcification seriously.

关 键 词：血液透析 骨化三醇 钙化评分 危险因素 

分 类 号：R459.5[医药卫生—治疗学]