慢性肾脏病患者维生素D_3水平变化及其相关因素分析  

Vitamin D_3 Levels in Patients with Chronic Kidney Disease and its Related Factors

作　　者：陈凯[1] 王昱[1] 王成军[1] 张清[1] 鲍晓荣[1] 

机构地区：[1]复旦大学附属金山医院,上海201508

出　　处：《中国中西医结合肾病杂志》2015年第2期125-127,共3页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：复旦大学附属金山医院基金资助项目[No.2013-16(院)]

摘　　要：目的：分析慢性肾脏病（CKD）患者活性维生素D3水平变化及其相关因素。方法：检测2013年4月~2014年6月本院新诊断的143例非透析CKD患者及19例同期健康体检者维生素D3水平,分析其与肾功能、成纤维细胞生长因子23（血FGF-23）、血钙、血磷、甲状旁腺素（PTH）等指标的关系。结果：CKD1~5期患者维生素D3水平分别为（22.03±4.39）ng/ml、（20.29±4.66）ng/ml、（16.88±3.00）ng/ml、（13.71±2.99）ng/ml、（9.76±2.97）ng/ml,与对照组（25.68±4.08）ng/ml相比,各组间维生素D3水平逐渐下降（P〈0.05）。维生素D3水平与血肌酐（r=-0.676）、尿素氮（r=-0.554）、血磷（r=-0.248）、钙磷乘积（r=-0.178）、PTH（r=-0.636）、FGF-23（r=-0.690）呈负相关（P〈0.05）,与血钙（r=0.157）、白蛋白（r=0.164）、肾小球滤过率e GFR（r=0.759）呈正相关（P〈0.05）,多元逐步回归分析显示维生素D3与e GFR呈正相关,与PTH呈负相关。回归方程为Y=13.196＋0.092X1-0.016X2（Y为维生素D3,X1为e GFR,X2为PTH,13.196为常数）。结论：随着CKD的进展,患者活性维生素D3缺乏日益严重,且与钙磷代谢紊乱、继发性甲旁亢及FGF-23升高相关。Objective： To explorer the relationship between serum 25（ OH） D3（ vitamin D3） level and it＇s related factors in patients with chronic kidney disease（ CKD）. Methods： 143 non- maintance hemodialysis CKD patients（ newly diagnosed during2013. 4 ~ 2014. 6） were enrolled,as well as 19 cases of healthy controls（ control group）,and the levels of vitamin D3,calcium,phosphorus,parathyroid hormone（ PTH）,urea nitrogen,creatinine,albumin,and fibroblast growth factors- 23（ FGF- 23） were detected. Meanwhile,glomerular filtration rate（ GFR） was calculated. Results： The level of 25（ OH） D3 in stage 1- 5 CKD patients were（ 22. 03 ± 4. 39） ng / ml,（ 20. 29 ± 4. 66） ng / ml,（ 16. 88 ± 3. 00） ng / ml,（ 13. 71 ± 2. 99） ng / ml and（ 9. 76 ± 2. 97） ng / ml.Compared with control group,serum vitamin D3 level of CKD patients were significantly lower（ P〈0. 05）. Significant negative correlations could been observed between serum vitamin D3leve1 and blood creatinine,BUN,phosphorus,calcium- phosphorus product,PTH and FGF- 23 levels and positive correlations between blood vitamin D3 level and blood calcium,albumin and e GFR leve1 were confirmed（ P〈0. 05）. PTH and e GFR entered the regression equation： Y = 13. 196 ＋ 0. 092X1- 0. 016X2,Y meant vitamin D3,X1 e GFR,X2 PTH. Conclusion： With the progression of CKD,vitamin D3 deficient patients is becoming increasingly serious,and was related with the calcium metabolism,phosphorus metabolism,secondary hyperparathyroidism and elevated FGF- 23.

关 键 词：维生素D3 慢性肾脏病 成纤维细胞生长因子-23 

分 类 号：R692.5[医药卫生—泌尿科学]