老年维持性血液透析患者钙磷代谢异常分析  

Abnormal Metabolismin of Calcium and Phosphorus in the Elderly Undergoing Maintenance Hemodialysis

作　　者：王志宏[1] 申飞梅[1] 朱爱国[1] 齐华林 Wang Zhihong;Shen Feimei;Zhu Aiguo;Qi Hualin(Department of Nephrology,the People's Hospital of Pudong New Area,Shanghai,201200,P.R.China)

机构地区：[1]上海市浦东新区人民医院肾内科

出　　处：《老年医学与保健》2019年第5期641-643,共3页Geriatrics & Health Care

摘　　要：目的调查老年维持性血液透析患者钙磷代谢状况,并评估高磷血症的危险因素,为临床治疗提供依据。方法调查本透析中心2015年1月—2018年4月共102例老年维持性血液透析患者的一般资料,检测其血钙、血磷、血全段甲状旁腺素(iPTH)、血红蛋白(Hb)、胆固醇和甘油三酯等指标,计算其达标率,与DOPPS4结果比较,根据患者年龄,分为65~75岁组和75岁以上组,两组比较并分析高磷血症的相关危险因素。结果102例老年血透患者血磷达标率24.5%,血钙达标率15.7%,血iPTH达标率19.6%,均低于透析预后实践模式(DOPPS4)组。年龄75岁以上组的患者血HB和血钙达标率低于年龄65~75岁组,其高磷血症的发生率亦低于65~75组。回归分析提示,年龄、透析龄、血iPTH水平与老年血透患者高磷血症密切相关。结论老年维持性血液透析患者血钙、磷、iPTH达标率低,年龄、透析龄、血iPTH水平是影响老年血透患者高磷血症的危险因素。Objective To investigate the metabolismof calciumand phosphorus in the elderly undergoing maintenance hemodialysis and to evaluate the risk factors of hyperphosphatemia.Methods The general data of 102 elderly undergoing maintenance hemodialysis during the period from January 2015 to April 2018 were collected and analysized;the levels of serum calcium,serum phosphorus,immunoreactive parathyroid hormone(iPTH),Hb,cholesterol and triglycerides of all the cases were detected,the standard-reaching rates were calculated and compared with those in DOPPS4 research results;the cases were divided,according to the age,into 2 groups:groupA(65 to 75 years old)and groupB(over 75 years old);a comparative study was made between the 2 groups and the related risk factors were analyzed.Results The standardreaching rates of phosphorus,calcium and iPTH in the 102 cases were 24.5%,15.7%and 19.6%respectively,lower than those in DOPPS4 research results;the standard-reaching rates of serumHB,serumcalciumand the rate of hyperphosphatemia in group B were lower than those in group A;Regression Analysis indicated that age,years of undergoing dialysis and iPTH level were in close correlation to hyperphosphatemia in the elderly undergoing maintenance hemodialysis.Conclusions The standard-reaching rates of serum calcium,serum phosphorus and iPTH are low in the elderly undergoing maintenance hemodialysis and age,years of undergoing dialysis and iPTH level are the risk factors.

关 键 词：老年 血液透析 血钙 血磷 甲状旁腺素 

分 类 号：R69[医药卫生—泌尿科学]