血液透析患者踝臂指数与血磷水平的相关性分析  

Correlation between ankle brachial index and serum phosphorus level in patients on hemodialysis

作　　者：吴传林 韦海棠 胡海棠 李金梅 童晶晶 

机构地区：[1]顺德区第一人民医院附属陈村医院内二科,广东佛山528313 [2]顺德区第一人民医院附属陈村医院手术室,广东佛山528313 [3]顺德区第一人民医院附属陈村医院肾内科,广东佛山528313 [4]顺德区第一人民医院附属陈村医院血液净化中心,广东佛山528313

出　　处：《广州医科大学学报》2016年第3期68-70,74,共4页Academic Journal of Guangzhou Medical University

基　　金：基金项目:佛山市顺德区医学科研立项(2015B015)

摘　　要：目的:通过分析血液透析患者踝臂指数(ABI)与血磷水平相关性,为临床下肢外周动脉病(PAD)的防治提供重要依据。方法:以本院2015年1月至2015年12月收治的200例终末期肾病维持性血液透析患者为研究对象,均行ABI测量,根据ABI测量结果将患者分为合并PAD组(ABI<0.9,40例)与非PAD组(ABI≥0.9,160例),测定并比较两组血脂、血压、血清肌酐、血磷、血钙等指标。结果:两组血压、血糖、血脂、血清肌酐、尿素氮各指标比较差异无统计学意义(P>0.05)。PAD组血磷、钙磷乘积、全段甲状旁腺素(iPTH)、超敏C反应蛋白(hsCRP)水平分别为(2.08±0.32)mmol/L、(56.4±5.6)mg^2/dL^2、(413.2±235.1)pg/m L、(8.0±1.2)mg/L,均明显高于非PAD组的(1.65±0.49)mmol/L、(44.1±8.8)mg^2/dL^2、(208.8±172.5)pg/m L、(3.5±1.3)mg/L(P<0.01)。Logistic回归分析血磷、钙磷乘积、i PTH及hs CRP是影响ABI的独立因素。结论:高磷血症、高i PTH及微炎症状态参与血液透析患者PAD发病进程。Objective：To investigate the correlation between ankle brachial index （ ABI ） and serum phosphorus level in hemodialysis patients, and to provide an important basis for the clinical prevention and treatment of peripheral arterial disease （ PAD） of lower limbs. Methods： A total of 200 hospitalized patients with end-stage renal disease on maintenance hemodialysis in our hospital between January 2015 and December 2015 were included as the subjects in the study. All patients underwent ABI measurement. According to the findings of ABI, the patients were divided into the combined PAD group （ ABI〈0.9, n=40） and non-PAD group （ ABI≥0.9160, n=160） . Blood lipids, blood pressure, serum creatinine, serum phosphorus, and blood calcium in the two groups were determined and compared. Results：There were no statistically significant differences in blood pressure, blood glucose, blood lipids （ TG, TC, LDL-C, HDL-C） , SCr, and BUN between the two groups （ P〉0.05） . The levels of serum phosphorus, calcium-phosphorus product, iPTH and hsCRP in the PAD group [（2.08±0.32） mmol/L, （56.4±5.6） mg^2/dl^2, （413.2±235.1） pg/ml, （8.0±1.2） mg/L]were significantly higher than those in the non-PAD group [（1.65±0.49） mmol/L, （44.1±8.8） mg^2/dl^2, （208.8±172.5） pg/ml, （3.5±1.3） mg/L]（P〈0.01）. Logistic regression analysis showed that serum phosphorus, calcium-phosphorus product, iPTH and hsCRP were the independent factors influencing ABI. Conclusion：Hyperphosphatemia, high iPTH and micro-inflammatory state are involved in the progression of PAD in patients on hemodialysis.

关 键 词：血液透析 踝臂指数 血磷 下肢外周动脉病 相关性 

分 类 号：R692.5[医药卫生—泌尿科学]