血液透析患者蛋白质能量消耗与甲状旁腺激素水平相关性  

Association of parathyroid hormone with protein-energy wasting in hemodialysis patients

作　　者：董娉婷 卓银霞[1] 钱光荣[1] 唐晓飞[1] 李瑾[1] 杨乐川 DONG Pingting;ZHUO Yinxia;QIAN Guangrong;TANG Xiaofei;LI Jin;YANG Lechuan(Department of Nephrology,Ma′anshan People′s Hospital,Ma′anshan 243000,Anhui,China)

机构地区：[1]马鞍山市人民医院肾内科,安徽马鞍山243000

出　　处：《皖南医学院学报》2024年第3期238-241,共4页Journal of Wannan Medical College

基　　金：安徽省卫生健康科研项目(AHWJ2022b111);马鞍山市人民医院青年科研基金(YQ-2021-4)。

摘　　要：目的:探讨维持性血液透析(MHD)患者蛋白质能量消耗(PEW)与甲状旁腺激素(PTH)水平相关性。方法:收集2021年1~12月在马鞍山市人民医院透析中心治疗的102例MHD患者临床资料及人体测量数据,采用国际肾脏营养及代谢协会制定的PEW诊断标准,纳入肌肉组织指数(LTI)、体细胞质量指数(BCMI)指标。根据PTH水平将患者分为低PTH组(PTH<150 pg/mL)、PTH目标组(150 pg/mL≤PTH<600 pg/mL)、高PTH组(600 pg/mL≤PTH<1000 pg/mL)、PTH极高组(PTH≥1000 pg/mL),采用Logistic回归分析PTH水平与PEW发生风险的关系。结果:MHD患者PEW发生率49%(50/102),低PTH组多项营养指标低于PTH目标组(P<0.05),PTH极高组部分营养指标低于PTH目标组(P<0.05)。根据营养不良-炎症评分(MIS)对患者PEW进行分度,不同PTH组患者PEW营养不良严重程度差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示透析龄增长、低PTH水平(P<0.05)是发生PEW的危险因素。结论:MHD患者PEW发生率较高,血清PTH水平与PEW发生密切相关,临床应重视并注意早期防治。Objective:To investigate the correlation between protein-energy wasting(PEW)and parathyroid hormone(PTH)level in patients undergoing maintenance hemodialysis(MHD).Methods:Clinical and anthropometric data were obtained in 102 patients undergoing MHD in the dialysis center of our hospital between January and December of 2021.PEW diagnostic criteria were established in compliance with the International Society of Renal Nutrition and Metabolism plus lean tissue index(LTI)and body cell mass index(BCMI).Then the patients were assigned to low PTH group(PTH<150 pg/mL),target PTH group(150≤PTH<600 pg/mL),high PTH group(600≤PTH<1000 pg/mL)or extremely high PTH group(PTH≥1000 pg/mL)by the determined PTH level.Logistic regression model was used to analyze the relationship between PTH level and the risks of PEW.Results:Incidence of PEW was 49%%(50/102)in the MHD patients.Several nutritional indicators in the low PTH group were lower than those in the target PTH group(P<0.05),and partial nutritional indicators of the extremely high PTH group were significantly lower than those of the PTH target group(P<0.05).Patients with PEW were graded according to the MIS score.The results showed that severity of malnutrition differed greatly in patients among different PTH groups(P<0.05).Multivariate logistic regression analysis demonstrated that added age at dialysis and low PTH level were associated with the risks of PEW(P<0.05).Conclusion:The incidence of PEW appears relatively higher in MHD patients,and serum PTH level is related to the occurrence of PEW,which suggests that clinical attention should be paid to early prevention and treatment in such patients.

关 键 词：血液透析 蛋白质能量消耗 甲状旁腺激素 

分 类 号：R692.5[医药卫生—泌尿科学] R581[医药卫生—外科学]