维持性血液透析患者矿物质代谢不达标状况及其危险因素分析  

Analysis of mineral metabolism non-compliance and risk factors in maintenance hemodialysis patients

作　　者：郭姗姗 Guo Shan-shan(Department of Nephrology,The Affiliated Hospital of Xinyang Vocational and Technical College,Xinyang 464000,Henan,China)

机构地区：[1]信阳职业技术学院附属医院肾内科,河南信阳464000

出　　处：《四川生理科学杂志》2025年第2期291-294,共4页

摘　　要：目的:分析维持性血液透析患者矿物质代谢不达标状况及其危险因素。方法:选取2021年1月至2022年6月期间于本院就诊的50例维持性血液透析患者作为研究对象。根据患者入组后首次透析前的空腹血钙、血磷、全段甲状旁腺激素(intact parathyroid hormone,iPTH)水平测定矿物质代谢不达标率,并根据结果将患者分为达标组(n=9)和未达标组(n=41)。采集患者的人口学资料,测定其总胆固醇(Total cholesterol,TC)、甘油三酯(Triglyceride,TG)、尿素氮(Blood Urea Nitrogen,BUN)、肌酐(Serum creatinine,Scr)、血清白蛋白(Albumin,ALB)碱性磷酸酶(Alkaline phosphatase,ALP)水平。分析患者矿物质代谢不达标的危险因素。结果:全部50例患者中,血钙、血磷、iPTH三项均达标的有9例,达标率为18.00%,其余41例为未达标,未达标率为82.00%。达标与未达标患者的性别、年龄、体质量指数、高血压史、透析频率、TC、TG、Scr、ALB无明显差异(P>0.05),达标组的有糖尿病史占比、透析时间、规律服用磷结合剂振臂、BUN水平、ALP水平均明显低于未达标组(P<0.05)。Logistic回归分析结果显示:有糖尿病史、透析时间长、未规律服用磷结合剂、BUN过表达、ALP过表达均是为维持性血液透析患者矿物质代谢不达标可能的危险因素(OR>1,P<0.05)。结论:矿物质代谢不达标在维持性血液透析患者中的发生情况十分普遍,其发生可能与患者既往有糖尿病史、透析时间较长、未规律服用磷结合剂、BUN过表达、ALP过表达等有关。Objective:To analyze the status and risk factors of mineral metabolism non-compliance in maintenance hemodialysis patients.Methods:Fifty patients with maintenance hemodialysis who were admitted to our hospital from January 2021 to June 2022 were selected as the study objects.The sub-standard rate of mineral metabolism was determined according to the fasting blood calcium,blood phosphorus and whole parathyroid hormone(iPTH)levels of the patients before dialysis,and the patients were divided into a qualified group(n=9)and a non-qualified group(n=41)according to the results.The demographic data of the patients were collected and the levels of total cholesterol(TC),triglyceride(TG),urea nitrogen(BUN),creatinine(Scr)and serum albumin(ALB)alkaline phosphatase(ALP)were determined.The risk factors of mineral metabolism substandard were analyzed.Results:Among all 50 patients,9 cases reached the standard of blood calcium,blood phosphorus and iPTH,the rate was 18.00%,and the other 41 cases were not up to the standard,the rate was 82.00%.There were no significant differences in gender,age,body mass index,hypertension history,dialysis frequency,TC,TG,Scr and ALB between the eligible and non-eligible patients(P>0.05),while the proportion of diabetes history,dialysis time,regular use of phosphorus binding agent arm shaking,BUN level and ALP level in the qualified group were lower than those in the non-qualified group,and the difference was statistically significant(P<0.05).Logistic regression analysis showed that history of diabetes,long dialysis time,irregular use of phosphorus binders,BUN overexpression and ALP overexpression were all possible risk factors for mineral metabolism substandard in maintenance hemodialysis patients(OR>1,P<0.05).Conclusion:The occurrence of mineral metabolism substandard is very common in maintenance hemodialysis patients,which may be related to the history of diabetes,long dialysis time,irregular use of phosphorus binders,BUN overexpression,ALP overexpression and so on.

关 键 词：维持性血液透析 矿物质代谢 达标率 糖尿病 磷结合剂 

分 类 号：R692.5[医药卫生—泌尿科学]