糖尿病维持性血液透析患者血清甲状旁腺素和碱性磷酸酶水平变化及与其心血管事件发生的关系  

Changes of serum levels of parathyroid hormone andalkaline phosphatase and their relationship withcardiovascular events in diabetic maintenancehemodialysis patients

作　　者：周淑琴 许华明 黄英英 ZHOU Shuqin;XU Huaming;HUANG Yingying(Department of Clinical Laboratory,Linchuan People's Hospital,Fuzhou,Jiangxi,344000,China)

机构地区：[1]抚州市临川区人民医院检验科,江西抚州344000

出　　处：《当代医学》2024年第4期155-158,共4页Contemporary Medicine

摘　　要：目的分析糖尿病维持性血液透析(MHD)患者血清甲状旁腺素(PTH)、碱性磷酸酶(ALP)水平变化及其与心血管事件发生的关系。方法回顾性分析2019年10月至2021年11月抚州市临川区人民医院收治的90例糖尿病MHD患者的临床资料,采用本院自制的问卷收集患者的社会人口学资料和实验室指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血红蛋白(Hb)、白蛋白(Alb)、总蛋白(TP)、尿素氮(BUN)、血清肌酐(SCr)及钙离子(Ca^(2+))],均进行血清甲状旁腺素(PTH)、碱性磷酸酶(ALP)水平检测。统计MHD患者心血管事件发生情况,采用单因素及多因素Logistic回归分析糖尿病MHD患者发生心血管事件的影响因素。结果90例患者中,发生心血管事件36例,发生率为40.00%,未发生54例。发生心血管事件与未发生患者性别、年龄及TC、TG、HDL-C、LDL-C、Hb、Alb、TP、BUN、SCr、Ca^(2+)水平比较差异无统计学意义;发生心血管事件患者血清PTH、ALP水平均高于未发生患者,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,血清PTH、ALP水平升高是MHD患者发生心血管事件的独立危险因素(OR>1,P<0.05)。结论血清PTH、ALP水平是糖尿病MHD患者发生心血管事件的危险因素,且血清PTH、ALP水平升高会增加糖尿病MHD患者发生心血管事件的风险,临床应制定针对性预防措施,以降低糖尿病MHD心血管事件发生率。Objective To analyze the changes of serum parathyroid hormone(PTH)and alkaline phosphatase(ALP)levels and their relationship with cardiovascular events in patients with diabetic maintenance hemodialysis(MHD).Methods The clinical data of 90 diabetic MHD patients ad-mitted to Linchuan People's Hospital from October 2019 to November 2021 were retrospectively analyzed.The sociodemographic data and laborato-ry indexes(Total cholesterol[TC],triglycerides[TG],high density lipoprotein cholesterol[HDL-C],low density lipoprotein cholesterol[LDL-C],he-moglobin albumin[Hb],albumin[Alb],total protein[TP],urea nitrogen[BUN],serum creatinine[SCr],and calcium ion[Ca^(2+)])were collected by self-made questionnaire in our hospital,and the serum PTH and ALP levels were detected.The incidence of cardiovascular events in MHD patients was counted,univariate and multivariate Logistic regression were used to analyze the influencing factors of cardiovascular events in diabetic MHD patients.Results Among the 90 patients,36 had cardiovascular events,with an incidence of 40.00%,and 54 had no cardiovascular events.There were no significant differences in gender,age and TC,TG,HDL-C,LDL-C,Hb,Alb,TP,BUN,SCr and Ca^(2+)levels between patients with and with-out cardiovascular events;serum PTH and ALP levels in patients with cardiovascular event were higher than those in patients without cardiovascular event,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that increased serum PTH and ALP levels were independent risk factors for cardiovascular events in MHD patients(OR>1,P<0.05).Conclusion Serum PTH and ALP levels are the factors affecting the occurrence of cardiovascular events in diabetic MHD patients,and the increase in serum PTH and ALP levels will increase the risk of cardiovascular events in diabetic MHD patients.Clinical prevention measures should be developed to reduce the incidence of cardiovascu-lar events in diabetic MHD patients.

关 键 词：持性血液透析 糖尿病 心血管事件 血清碱性磷酸酶 甲状旁腺素 

分 类 号：R587.2[医药卫生—内分泌] R692.5[医药卫生—内科学]