血清iPTH、Ca、P和血液透析患者死亡率之间的关系  

Association between serum iPTH, calcium and phosphate, and the risk of mortality in haemodialysis population

作　　者：王慧[1] 彭佑铭[1] Wang Hui Peng Youming(Department of Nephrology, the Second Xiangya Hospital of Central South University, Changsha 410011, China)

机构地区：[1]中南大学湘雅附二院肾内科,湖南长沙410011

出　　处：《国际泌尿系统杂志》2017年第3期399-402,共4页International Journal of Urology and Nephrology

摘　　要：目的 探讨长沙市第一医院血透患者CKD-MBD标志物的达标率,以及它们和血液透析患者死亡率之间的关系.方法 对2014年1月至2016年12月期间,在本院进行血液透析的177例患者的病史、实验室检查结果进行了回顾性分析.以2009年KDIGO指南为标准,了解177例患者CKD-MBD标志物的达标率.根据临床结局将患者分为死亡组35例,存活组142例.使用广义估计方程比较死亡组和存活组患者的iPTH、钙、磷.再用Logistic回归模型评估血透患者血清磷、钙和甲状旁腺素与全因死亡率之间的关系.结果 本院177例血透患者中,有102例（57.6％）血清钙浓度、51例（28.8％）血清磷浓度、81例（45.8％） iPTH达到指南标准.死亡组和存活组患者的钙、iPTH有差异,而磷无差异.在本次研究中,钙和磷与血透患者的全因死亡率相关,而iPTH与全因死亡率无关.结论 本研究所显示的结果要不同于之前欧美国家观察性研究的结果,KDIGO指南的建议是否适合中国血透人群仍需要进一步的证明.Objectives To explore control rates of CKD-MBD markers in hemodialysis patients in the first hospital of changsha,and evaluate the association between CKD-MBD markers and mortality.Methods A retrospective general data and laboratory test results of 177 HD patients who received regular outpatient HD in the hospital from January 2014 until December 2016 were performed.The control rate of CKD-MBD markers were evaluated based on the KDIGO clinical guidelines.According to the clinical outcome,the patients were divided into the death group （n =35） and the survival group （n =142）.iPTH,P and Ca were compared between the two groups by generalized estimating equation.A logistic regression model was used to evaluate the relationship between serum Ca,P and iPHT levels and the risk for all-cause mortality.Results In the 177 cases,normal serum Ca was found in 102 （57.6%）cases,normal phosphate in 51 （28.8%） cases and normal iPTH in 81 （45.8%） cases.There were differences in our study between surviving and non-surviving patients＇ Ca and iPTH,and no difference in P.In our study,all-cause mortality was associated with increased levels of Ca and P in hemodialysis patients,and iPTH levels were not significantly associated with all-cause mortality.Conclusions The results of the study are different from the results of previous observational studies in Europe and the United States.Whether the suggestions of KDIGO Guidelines are suitable for Chinese hemodialysis patients still needs further evidences.

关 键 词：肾透析 钙 磷 死亡率 

分 类 号：R692.5[医药卫生—泌尿科学]