腹膜透析患者钙磷代谢达标的影响因素分析  

Analysis of influencing factors of calcium and phosphorus metabolism up to standard in peritoneal dialysis patients

作　　者：刘芸芳[1] 曾春[1] 唐盛[1] 韦俏宇[1] Liu Yunfang;Zeng Chun;Tang Sheng;Wei Qiaoyu(Department of Nephrology,People’s Hospital of Guangxi Zhuang Autonomous Region,Guangxi Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院肾内科,广西南宁530021

出　　处：《中国医刊》2022年第6期626-630,共5页Chinese Journal of Medicine

基　　金：广西壮族自治区卫生健康委员会科研课题(Z20190773)。

摘　　要：目的探讨腹膜透析患者钙磷代谢达标的影响因素。方法选取2018年6月至2020年6月广西壮族自治区人民医院收治的136例腹膜透析患者为研究对象,根据透析液钙浓度不同将研究对象分为低钙浓度腹膜透析液组(45例)和标准钙浓度腹膜透析液组(91例)。分析患者治疗后的血清钙、磷和甲状旁腺激素(parathyroid hormone,iPTH)达标情况。根据血清钙是否达标将研究对象分为钙达标组(65例)和钙不达标组(71例);根据血清磷是否达标将研究对象分为磷达标组(60例)和磷不达标组(76例);根据血清iPTH是否达标将研究对象分为iPTH达标组(21例)和iPTH不达标组(115例)。分析腹膜透析患者血清钙、磷和iPTH达标的影响因素。结果腹膜透析患者的血清钙、磷和iPTH达标率分别为47.79%、44.12%和15.44%。低钙浓度腹膜透析液组和标准钙浓度腹膜透析液组患者的血清钙、磷和iPTH达标率比较差异均无显著性(P>0.05)。磷不达标组患者的年龄和基线血肌酐水平均显著高于磷达标组(P<0.05),多因素logistic回归分析结果显示,年龄、基线血肌酐水平是腹膜透析患者血清磷达标的独立影响因素(P<0.05)。结论腹膜透析患者发生钙磷代谢紊乱的比例仍较高,而不同钙浓度腹膜透析液对患者钙磷代谢的影响无明显差异,且血清磷达标情况受患者年龄和基线血肌酐水平的影响。Objective To explore the influencing factors of calcium and phosphorus metabolism in peritoneal dialysis.Method 136 patients undergoing peritoneal dialysis treated in the People’s Hospital of Guangxi Zhuang Autonomous Region from June 2018 to June 2020 were selected as the research objects.According to the calcium concentration of dialysate,the subjects were divided into low calcium dialysate group(45 cases)and standard calcium dialysate group(91 cases).The levels of serum calcium,phosphorus and Parathyroid hormone(iPTH)after treatment were analyzed.According to the serum calcium standard,the subjects were divided into calcium standard group(65 cases)and non-calcium standard group(71 cases).According to whether the serum phosphorus reached the standard,the subjects were divided into the standard phosphorus group(60 cases)and the non-standard phosphorus group(76 cases).According to whether the serum iPTH reached the standard,the subjects were divided into the iPTH reaching the standard group(21 cases)and the non-iPTH reaching the standard group(115 cases).To analyze the influencing factors of serum calcium,phosphorus and iPTH in peritoneal dialysis patients.Result The standard rates of serum calcium,phosphorus and iPTH were 47.79%,44.12%and 15.44%.There were no significant differences in the attainment rates of serum calcium,phosphorus and iPTH between low calcium dialysate group and standard calcium dialysate group(P>0.05).The age and baseline serum creatinine(Scr)of patients with non-standard phosphorus group were significantly higher than those of patients with standard phosphorus group(P<0.05).Logistic regression analysis showed that age and baseline Scr were independent influencing factors of serum phosphorus standard(P<0.05).Conclusion The proportion of calcium and phosphorus metabolism disorders in peritoneal dialysis patients is still high,and there is no significant difference in the effect of peritoneal dialysis with different calcium concentrations on bone metabolism in patients,and the standard of se

关 键 词：腹膜透析 钙磷代谢 钙浓度 腹膜透析液 甲状旁腺激素 

分 类 号：R692[医药卫生—泌尿科学]