维持性血液透析患者钙磷代谢紊乱与营养-炎症状态相关性分析  

Correlation analysis of calcium-phosphorus metabolism disorder with nutritional-inflammatory status in patients with maintenance hemodialysis

作　　者：章玉 莫立稳 张青云 唐婉琴 范晓栋 ZHANG Yu;MO Liwen;ZHANG Qingyun;TANG Wanqin;FAN Xiaodong(Department of Nephrology,Western Theater General Hospital,Chengdu 610057,China)

机构地区：[1]解放军西部战区总医院肾脏病科,四川成都610057

出　　处：《陕西医学杂志》2024年第9期1197-1201,共5页Shaanxi Medical Journal

基　　金：四川省自然科学基金资助项目(2023NSFSC0602)。

摘　　要：目的:分析维持性血液透析(MHD)患者钙磷代谢紊乱与营养-炎症状态的相关性。方法:选取接受MHD治疗的患者513例,检测血清钙磷代谢指标[血磷(P)、血钙(Ca)、全段甲状旁腺激素(iPTH)、钙磷乘积]和营养-炎症状态指标[白蛋白(ALB)、血红蛋白(Hb)、体重指数(BMI)、高敏C-反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)],采用营养不良-炎症评分(MIS)评估患者营养-炎症状态。根据血清钙、磷水平将患者分为钙磷代谢紊乱组和钙磷代谢正常组,根据MIS评分将患者分为营养不良组和非营养不良组,比较上述指标的组间差异。采用Pearson法分析MHD患者钙磷代谢与营养-炎症状态指标的相关性。结果:钙磷代谢紊乱组P、iPHT、钙磷乘积高于钙磷代谢正常组,Ca低于钙磷代谢正常组(均P<0.05)。钙磷代谢紊乱组ALB、Hb、BMI低于钙磷代谢正常组,hs-CRP、TNF-α、IL-6和MIS评分高于钙磷代谢正常组(均P<0.05)。营养不良组P、iPHT、钙磷乘积高于非营养不良组,Ca低于非营养不良组(均P<0.05)。营养不良组ALB、Hb、BMI低于非营养不良组,hs-CRP、TNF-α、IL-6和MIS评分高于非营养不良组(均P<0.05)。Pearson相关分析结果显示,P、iPHT、钙磷乘积与ALB、HB、BMI呈负相关,与hs-CRP、TNF-α、IL-6、MIS评分呈正相关;Ca与ALB、HB、BMI呈正相关,与hs-CRP、TNF-α、IL-6、MIS评分呈负相关(均P<0.05)。结论:MHD患者钙磷代谢紊乱与营养-炎症状态相关。Objective:To analyze the correlation between calcium-phosphorus metabolism disorder and nutritional-inflammatory status in patients undergoing maintenance hemodialysis(MHD).Methods:A total of 513 patients who underwent MHD were selected.Serum phosphorus(P),serum calcium(Ca),intact parathyroid hormone(iPTH),calcium-phosphorus product and albumin(ALB),hemoglobin(Hb),Body Mass Index(BMI),high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)were detected,and Malnutrition-Inflammation Score(MIS)was used to evaluate the nutritional-inflammatory status of patients.According to the levels of serum calcium and phosphorus,the patients were classified into calcium-phosphorus metabolism disorder group and normal calcium-phosphorus metabolism group.By means of the MIS score,the patients were divided into malnutrition group and non-malnutrition group.The differences in the above indicators were compared.Pearson correlation coefficient was performed to analyze the correlation between calcium-phosphorus metabolism and nutritional-inflammatory status indicators in MHD patients.Results:The P,iPHT and calcium-phosphorus product in calcium-phosphorus metabolism disorder group were higher than those in normal calcium-phosphorus metabolism group,while the Ca was lower than that in normal calcium-phosphorus metabolism group(all P<0.05).The ALB,Hb and BMI were lower while the hs-CRP,TNF-α,IL-6 and MIS score in calcium-phosphorus metabolism disorder group were higher than those in normal calcium-phosphorus metabolism group(all P<0.05).The P,iPHT and calcium-phosphorus product in malnutrition group were higher while the Ca was lower compared to non-malnutrition group(all P<0.05).The ALB,Hb and BMI in malnutrition group were lower than those in non-malnutrition group while the hs-CRP,TNF-α,IL-6 and MIS score were higher(all P<0.05).Pearson correlation analysis showed that P,iPHT and calcium-phosphorus product were negatively correlated with ALB,HB and BMI,and positively correlated with hs-CRP,TN

关 键 词：维持性血液透析 钙磷代谢 全段甲状旁腺激素 营养-炎症状态 营养不良-炎症评分 相关性分析 

分 类 号：R692.5[医药卫生—泌尿科学]