血磷及甲状旁腺激素水平与维持性血液透析患者发生睡眠障碍的关系  

Relationships between blood phosphorus and parathyroid hormone levels and sleep disorders in maintenance hemodialysis patients

作　　者：潘孝婷 章子郁 王雪洁 杨振华[1] 高琛妮 陈晓农[1] PAN Xiaoting;ZHANG Ziyu;WANG Xuejie;YANG Zhenhua;GAO Chenni;CHEN Xiaonong(Department of Nephrology,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200052,China)

机构地区：[1]上海交通大学医学院附属瑞金医院肾脏内科,上海200052 [2]上海交通大学医学院附属瑞金医院卢湾分院肾脏内科,上海200020

出　　处：《山东医药》2025年第1期15-18,共4页Shandong Medical Journal

基　　金：上海市临床重点专科项目(shslczdzk02502);上海市健康科普人才能力提升专项(JKKPYC-2024-A06)。

摘　　要：目的探讨血磷及甲状旁腺激素(PTH)水平与维持性血液透析(MHD)患者发生睡眠障碍的关系。方法选择100例MHD患者,根据匹兹堡睡眠质量指数(PSQI)量表评分将患者分为睡眠良好组29例、睡眠障碍组71例。比较两组临床资料,Logistic回归分析血磷、PTH对MHD患者发生睡眠障碍的影响,受试者工作特征(ROC)曲线评价血磷、PTH对MHD患者发生睡眠障碍的预测价值。结果睡眠障碍组血磷、PTH水平高于睡眠良好组(P均<0.05)。高血磷(OR=3.850,95%CI:1.496~9.908)、高PTH(OR=1.003,95%CI:1.001~1.006)是MHD患者发生睡眠障碍的独立危险因素(P均<0.05)。校正性别、年龄后,血磷每升高1 mmol/L,睡眠障碍发生风险升高约4.082倍;PTH每升高1 pg/mL,睡眠障碍发生风险升高约1.004倍。血磷、PTH联合预测MHD患者发生睡眠障碍的ROC曲线下面积高于二者单独预测(P均<0.05)。结论高血磷、高PTH的MHD患者易发生睡眠障碍,血磷联合PTH对MHD患者发生睡眠障碍有一定预测价值。Objective To explore the relationships between blood phosphorus and parathyroid hormone(PTH)levels and the sleep disorders in patients undergoing maintenance hemodialysis(MHD).Methods Totally 100 patients undergoing maintenance hemodialysis were enrolled.Patients were divided into two groups according to the Pittsburg Sleep Quality Index(PSQI)scale:the good sleepers(n=29)and poor sleepers(n=71).Clinical data were compared between two groups,and Logistic regression analysis was performed to identify the effects of blood phosphorus and PTH on sleep disorders among MHD patients.The predictive value of blood phosphorus and PTH for sleep disorders in MHD patients was evaluated by the receiver operating characteristic(ROC)curve.Results The blood phosphorus and PTH levels were significantly higher in the poor sleepers than in the good sleepers(both P<0.05).Hyperphosphatemia(OR=3.85,95%CI=1.496-9.908)and elevated PTH(OR=1.003,95%CI=1.001-1.006)were independent risk factors for sleep disorders in MHD patients(both P<0.05).After adjusting gender and age,for every 1 mmol/L increase in blood phosphorus,the risk of sleep disorders increased by 4.082 times;for every 1 pg/mL increase in PTH,the risk of sleep disorders increased by 1.004 times.The area under the ROC curve of blood phosphorus and PTH in prediction of sleep disorders in MHD patients was higher than that of either alone(both P<0.05).Conclusion MHD patients with hyperphosphatemia and elevated PTH were prone to sleep disorders,and the combination of blood phosphorus and PTH had certain predictive value for the occurrence of sleep disorders in MHD patients.

关 键 词：维持性血液透析 血磷 甲状旁腺激素 睡眠障碍 

分 类 号：R459.5[医药卫生—治疗学]