维持性血液透析患者钙磷代谢紊乱的异常因素分析  

Abnormal factors analysis of calcium-phosphorus metabolism disorder in maintenance hemodialysis patients

作　　者：陈伟[1] 张江淮[1] 肖蓓[1] 陈雷[1] 陶金辉 

机构地区：[1]安徽医科大学第三附属医院、合肥市第一人民医院肾脏内科,合肥230032 [2]安徽医科大学附属省立医院风湿免疫科

出　　处：《中国临床保健杂志》2017年第3期244-246,共3页Chinese Journal of Clinical Healthcare

基　　金：安徽省自然科学基金项目(1708085MH191)

摘　　要：目的探讨维持性血液透析患者钙磷代谢紊乱的异常因素。方法对130例维持性血液透析患者的钙、磷浓度、钙磷浓度乘积及甲状旁腺激素(i PTH)进行测定,并与K/DOQI2003指南及KDIGO2009指南指标进行比较。结果 130例患者的血钙、血磷、钙磷乘积和i PTH以K/DOQI2003指南为标准,达标率分别为48.12%,48.23%,78.75%,20.28%;以KDIGO2009指南为标准,达标率分别为47.71%,28.74%,38.30%。血流量≥300 m L/min患者血磷水平较血流量<300 m L/min患者明显降低(t=2.892,P<0.05)。透析时间≥3年患者血钙、钙磷乘积和i PTH水平较透析时间<3年患者明显增高(t=2.479、5.681、3.012,P<0.05)。年龄≥50岁患者血磷、钙磷乘积水平较年龄<50岁患者明显降低(t=2.212、3.367,P<0.05)。结论维持性血液透析患者存在钙磷代谢异常,控制水平仍然达不到指南要求。随着时间延长,钙磷代谢紊乱问题有所加重。Objective To analyze the abnormal factors of the disorder status of calcium - phosphorus metab- lism in maintenance hemodialysis patients. Methods Serum calciun, serum phosphorus, calcium - phosphorus product and iPTH were detected in 130 patients with maintenance hemodialysis, and compared with the indicators of K/DOQI2003 and KDIG02009 guidelines. Results Eligibility rate about serum calcium and phosphorus and multipli-cation and the level of intact parathyroid hormone were 48. 12%, 4 8 .2 3% , 78. 7 5% , 20. 28% respectively by the indi-cators of K/DOQI2003 guidelines. There were 47. 71% ,28.74% ,38. 30% respectively by the indicators of KDIG02009 guidelines. The level of serum phosphorus was lower in patients whose blood flow over 300mL/min than patients whose blood flow less than 300mL/min（ t - 2. S92 ,P 〈 0. 05 ） . The level of serum calciun, calcium - phosphoris product and PTH were higher in patients whose hemodialysis vintage over 3 years than patients whose hemodialysis vintage lower 3 years （ t =2.479,5,681,3. 012 〈 0. 05 ）. The level of serum phosphorus and calcium - phosphoris product were lower in patientswhose age over 50 years than patients whose age lower 50 years（ t = 2. 212,3. 361 ,P 〈 0. 05 ） . Conclusion There is ab-normal calcium and phosphorus metabolism in the patients with maintenance hemodialysis,which don＇t reach the K/DOQI and KDIGO guidelines. As the dialysis time increase,the abnormal mineral metabolism become more obviously.

关 键 词：肾透析 钙代谢障碍 磷代谢障碍 甲状旁腺素 

分 类 号：R692.5[医药卫生—泌尿科学]