iPTH水平对慢性肾病肾性贫血患者病情程度的预测价值  

The predictive value of iPTH levels on the severity of renal anemia in patients with chronic kidney disease

作　　者：尤望秋 郑钦钦 YOU Wang-qiu;ZHENG Qin-qin(Fuzhou Second Hospital Laboratory Department,Fujian Fuzhou 350000)

机构地区：[1]福州市第二医院检验科,福建福州350000

出　　处：《医学检验与临床》2024年第12期17-21,共5页Medical Laboratory Science and Clinics

摘　　要：目的:分析慢性肾病肾性贫血患者病情程度的影响因素,探究iPTH水平对慢性肾病肾性贫血患者病情程度的预测价值。方法:回顾性分析2022年7月-2023年7月福州市第二医院收治的86例慢性肾病肾性贫血患者的病历资料,根据患者贫血程度将患者分为轻症组[血红蛋白(Hb)≥90g/LL]32例和中重症组(Hb<90g/L)54例。比较两组患者血清甲状旁腺激素(iPTH)、钙、磷、血红蛋白(Hb)、25-羟基维生素D(25(OH)D)、血尿素氮(BUN)水平,采用Logistic回归模型分析慢性肾病肾性贫血患者病情程度的影响因素,随后运用受试者工作特征曲线(ROC)分析iPTH水平对慢性肾病肾性贫血患者病情程度的预测价值。结果:单因素分析结果显示,两组患者吸烟、高血压、病程、iPTH、钙、磷、Hb、25(OH)D等指标比较具有差异(P<0.05)。多因素Logistic回归分析结果显示,iPTH、钙、磷、Hb、25(OH)D是慢性肾病肾性贫血患者病情程度的危险因素(P<0.05)。iPTH预测慢性肾病肾性贫血患者ROC曲线下面积为0.822(95%Cl:0.732~0.913),预测DN的最佳界截断值为0.566,敏感度为72.20%,特异度为84.40%。结论:iPTH、钙、磷、Hb、25(OH)D是慢性肾病肾性贫血患者病情程度的危险因素,iPTH对慢性肾病肾性贫血具备较高的预测价值。Objective:The purpose of this study is to analyze the influencing factors of the severity of renal anemia in patients with chronic kidney disease,and to explore the predictive value ofiPTH levels on the severity of renal anemia in patients with chronic kidney disease.Methods:Aretrospective analysis was conducted on the medical records of86 patients with chronic kidney disease and renal anemia admitted to the Second Hospital of Fuzhou City from July 2022 to July 2023.According to the degree of anemia,the patients were divided into a mild group(32 cases with hemoglobin(Hb)≥90 g/LL)and a moderate to severe group(54 cases with Hb<90 g/L).Compare the serum levels of parathyroid hormone(iPTH),calcium,phosphorus,hemoglobin(Hb),25 hydroxyvitamin D(25(OH)D),and blood urea nitrogen(BUN)between two groups of patients.Use a logistic regression model to analyze the influencing factors of the severity of chronic kidney disease renal anemia patients,and then use receiver operating characteristic curve(ROC)to analyze the predictive value ofiPTH levels on the severity of chronic kidney disease renal anemia patients.The results of single factor analysis showed that there were significant differences(P<0.05)in smoking,hypertension,disease duration,iPTH,calcium,phosphorus,Hb,25(OH)D and other indicators between the two groups of patients.The results of multivariate logistic regression analysis showed that iPTH,calcium,phosphorus,Hb,and 25(OH)D were risk factors for the severity of renal anemia in patients with chronic kidney disease(P<0.05).The area under the ROC curve predicted by iPTH for patients with chronic kidney disease and renal anemia is 0.822(95%Cl:0.732-0.913).The optimal cutoff value for predicting DN is 0.566,with a sensitivity of 72.20%and a specificity of 84.40%.Conclusion:iPTH,calcium,phosphorus,Hb,and 25(OH)D are risk factors for the severity of chronic nephrotic anemia in patients,and iPTH has high predictive value for chronic nephrotic anemia.

关 键 词：iPTH水平 慢性肾病 肾性贫血 病情严重程度 预测价值 

分 类 号：R69[医药卫生—泌尿科学]