血清Ca、P、iPTH、HbA1c表达水平与糖尿病肾病血透患者预后的相关性  

Correlation between Expression Levels of Serum Ca,P,iPTH and HbA1c and Prognosis of Patients with Diabetic Kidney Disease Undergoing Hemodialysis

作　　者：郭燕 GUO Yan(Shijingshan Teaching Hospital of Capital Medical University,Beijing 100043,China)

机构地区：[1]首都医科大学石景山教学医院(北京市石景山医院),北京100043

出　　处：《中外医学研究》2024年第3期162-165,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析血清钙(Ca)、磷(P)、全段甲状旁腺激素(iPTH)、糖化血红蛋白(HbA1c)表达水平与糖尿病肾病(DKD)血透患者预后的相关性。方法:回顾性分析2020年1月—2021年12月在首都医科大学石景山教学医院进行血液透析治疗的83例糖尿病肾病患者的临床资料。根据患者随访1年内非计划再入院情况分为预后较差组(n=21)与预后良好组(n=62)。比较两组透析治疗前血清Ca、P、iPTH、HbA1c表达水平。分析DKD血透患者血清Ca、P、iPTH、HbA1c水平与预后的关系。以受试者工作特征(ROC)曲线评估血清P、iPTH、HbA1c水平对DKD预后的预测价值。结果:预后良好组血清P、iPTH水平均高于预后较差组,HbA1c水平低于预后较差组,差异有统计学意义(P<0.05)。多因素logistic回归分析显示血清P、iPTH及HbA1c均是DKD血透患者预后的影响因素(P<0.05)。ROC结果显示,血清P、iPTH、HbA1c水平对DKD血透患者预后预测的AUC分别为0.659、0.871、0.855,具有较高的预测价值。结论:DKD血透患者预后与血清P、iPTH及HbA1c表达有关,临床可通过检测DKD血透者血清P、iPTH、HbA1c水平预测预后,并对预后较差者积极干预,以期改善患者预后。Objective:To analyze the correlation between expression levels of serum calcium(Ca),phosphorus(P),intact parathyroid hormone(iPTH)and glycosylated hemoglobin(HbA1c)and prognosis of patients with diabetic kidney disease(DKD)undergoing hemodialysis.Method:The clinical data of 83 patients with DKD who underwent hemodialysis in Shijingshan Teaching Hospital of Capital Medical University were retrospectively analyzed from January 2020 to December 2021.According to the unplanned readmission status of patients within 1 year of follow-up,they were divided into poor prognosis group(n=21)and good prognosis group(n=62).The levels of serum Ca,P,iPTH and HbA1c were compared between the two groups before dialysis,and the correlation between levels of serum Ca,P,iPTH and HbA1c and prognosis of patients with DKD undergoing hemodialysis were analyzed.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of levels of serum were analyzed P,iPTH and HbA1c on the prognosis of DKD.Result:The levels of serum P and iPTH of patients in good prognosis group were higher than those in poor prognosis group,while the HbA1c level was lower than that in poor prognosis group,the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed the levels of serum P and iPTH and HbA1c were influencing factors of patients with DKD undergoing hemodialysis(P<0.05).ROC results showed that the AUC values of serum P,iPTH and HbA1c were 0.659,0.871 and 0.855 respectively in the predictive of prognosis of patients with DKD undergoing hemodialysis,with high predictive value.Conclusion:The prognosis of patients with DKD undergoing hemodialysis is related to the expression of serum P,iPTH and HbA1c.Clinically,the serum P,iPTH and HbA1c levels of DKD hemodialysis patients can be detected to predict the prognosis,and active intervention can be conducted to improve the prognosis of patients with poor prognosis.

关 键 词：钙磷 全段甲状旁腺激素 糖化血红蛋白 糖尿病肾病 血液透析 预后 相关性 

分 类 号：R692.5[医药卫生—泌尿科学] R587.2[医药卫生—外科学]