高淳区血液净化中心维持性血液透析患者骨质疏松发生情况及影响因素  

Incidence of osteoporosis in maintenance hemodialysis patients at Gaochun district blood purification center and its influencing factors

作　　者：武蓓蓓 王秋平 陈瑶 仲晓 施婷婷 Wu Beibei;Wang Qiuping;Chen Yao;Zhong Xiao;Shi Tingting(Department of Hemodialysis,Nanjing Gaochun People′s Hospital,Nanjing 211300,China;Department of Orthopedics,Nanjing Gaochun People's Hospital,Nanjing 211300,China;Department of Hemodialysis,Nanjing Gaochun Hospital of Traditional Chinese Medicine,Nanjing 211300,China)

机构地区：[1]南京市高淳人民医院血透室,南京211300 [2]南京市高淳人民医院骨科,南京211300 [3]南京市高淳中医院血透室,南京211300

出　　处：《中国医师进修杂志》2025年第2期97-101,共5页Chinese Journal of Postgraduates of Medicine

基　　金：南京市卫生科技发展专项资金项目(YKK20174)。

摘　　要：目的调查南京市高淳区血液净化中心维持性血液透析(MHD)患者骨质疏松(OP)发生情况,并分析其影响因素。方法回顾性选取2019年1月至2023年12月于南京市高淳人民医院及南京市高淳中医院接受规律性MHD治疗的3622例患者为研究对象。收集患者人口学特征、合并症、血钙及血肌酐等临床资料。采用多因素Logistic回归模型分析MHD患者发生OP的影响因素。结果调查显示,33.63%的MHD患者骨量减少,37.24%的MHD患者发生OP。根据OP发生与否将3622例患者分为OP组(1349例)和非OP组(2273例)。单因素分析显示,与非OP组比较,OP组白蛋白(ALB)水平较低[(38.95±5.17)g/L比(40.32±5.84)g/L],差异有统计学意义(P<0.05);与非OP组比较,OP组免疫反应性甲状旁腺激素(iPTH)和碱性磷酸酶(ALP)水平较高[(262.29±36.76)ng/L比(249.55±32.73)ng/L、(114.74±18.01)U/L比(109.63±17.25)U/L],且年龄≥60岁、女性及透析时间≥5年的占比较高[61.75%(833/1349)比47.87%(1088/2273)、66.35%(895/1349)比54.86%(1247/2273)、52.34%(706/1349)比34.36%(781/2273)],差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,ALB(OR=0.724,95%CI 0.568~0.920)、iPTH(OR=1.374,95%CI 1.095~1.725)、ALP(OR=1.325,95%CI 1.070~1.641)、年龄(OR=2.753,95%CI 1.664~4.556)、性别(OR=2.993,95%CI 1.611~5.560)、透析时间(OR=4.216,95%CI 2.365~7.516)均为MHD患者发生OP的影响因素(P<0.05)。结论南京市高淳区MHD患者OP发生率高,且其发生与ALB、iPTH、ALP、年龄、性别、透析时间密切相关,临床上应重点关注。Objective To investigate the incidence of osteoporosis(OP)in maintenance hemodialysis(MHD)patients at the blood purification center in Gaochun district,and analyze its influencing factors.Methods A retrospective study was conducted on 3622 patients who received regular MHD treatment at Nanjing Gaochun People′s Hospital and Nanjing Gaochun Traditional Chinese Medicine Hospital from January 2019 to December 2023.The demographic characteristics,comorbidities,and clinical data such as blood calcium and creatinine of patients were collected.The ultivariate Logistic regression model was applied to analyze the influencing factors of OP in MHD patients.Results The survey revealed that 33.63%of MHD patients had decreased bone mass,and 37.24%of MHD patients experienced osteoporosis.According to the occurrence of OP,3622 patients were separated into the OP group(1349 cases)and the non-OP group(2273 cases).Univariate analysis showed that compared with the non-OP group,the albumin(ALB)level in the OP group was lower:(38.95±5.17)g/L vs.(40.32±5.84)g/L,there was statistical difference(P<0.05).Compared with the non-OP group,the levels of immunoreactive parathyroid hormone(iPTH)and alkaline phosphatase(ALP)in the OP group were higher:(262.29±36.76)ng/L vs.(249.55±32.73)ng/L,(114.74±18.01)U/L vs.(109.63±17.25)U/L,the proportion of patients aged≥60 years old,female and dialysis duration≥5 years was higher:61.75%(833/1349)vs.47.87%(1088/2273),66.35%(895/1349)vs.54.86%(1247/2273),52.34%(706/1349)vs.34.36%(781/2273),there were statistical differences(P<0.05).Multivariate Logistic regression revealed ALB(OR=0.724,95%CI 0.568-0.920),iPTH(OR=1.374,95%CI 1.095-1.725),ALP(OR=1.325,95%CI 1.070-1.641),age(OR=2.753,95%CI 1.664-4.556),gender(OR=2.993,95%CI 1.611-5.560),and dialysis time(OR=4.216,95%CI 2.365-7.516)were all influencing factors for the occurrence of OP in MHD patients(P<0.05).Conclusions The incidence of OP in MHD patients in Gaochun district is high,and its occurrence is closely related to ALB,iPTH,ALP,age,gender and

关 键 词：血液透析滤过 骨质疏松 骨量 影响因素 

分 类 号：R69[医药卫生—泌尿科学]