【摘要】 目的分析维持性血液透析(MHD)患者血清钙(Ca)、磷(P)及甲状旁腺激素(PTH)水平与透析充分性的相关性。方法以2016年1至12月北京大学深圳医院肾内科血液透析室行MHD治疗的患者120例为研究对象,均在治疗结束测定血清尿素(UN)浓度变化计算尿素清除指数(Kt/V),评估血液透析充分性,依据Kt/V值大小将其分为透析充分组(Kt/V≥1.2,n=70)、透析不充分组(Kt/V<1.2,n=50),比较两组基线资料及血清Ca、P、PTH、Kt/V值,分析MHD患者血清Ca、P、PTH与Kt/V值的相关性。结果透析充分组年龄[(46.18±4.75)岁]、每周透析时间[(13.70±1.39)h]、干体重[(52.18±5.36)kg]均低/短于透析不充分组,而血红蛋白[(79.25±8.10)g/L]、残余肾小球滤过率(GFR)[(2.88±0.29)mL/min(1.73 m2)]较透析不充分组高,差异有统计学意义(P<0.05);透析充分组血清Ca[(1.90±0.21)mmol/L]、P[(2.08±0.09)mmol/L]及PTH[(245.18±24.55)pg/mL]较透析不充分组低,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示MHD患者的透析充分性与血清钙、磷、PTH有相关性(P<0.05);Spearman相关分析结果显示MHD患者血清Ca、P、PTH与Kt/V值呈负相关(r=-0.328、-0.399、-0.294,P<0.05)。结论 MHD患者血清Ca、P及PTH与透析充分性存在一定相关性,血液透析患者在治疗期间需密切监测血清Ca、P及PTH水平。更多还原

【Abstract】 Objective To analyze the correlation between serum calcium(Ca),phosphorus(P)and parathyroid hormone(PTH)levels and dialysis adequacy in maintenance hemodialysis(MHD)patients. Methods 120 patients treated withMHD in the hemodialysis room of department of nephrology,Peking University Shenzhen Hospital from January 2016 toDecember 2016 were collected for the study,and their blood urea nitrogen(BUN)concentration changes and the ureaclearance index(Kt/V)were determined;the hemodialysis adequacy at the end of the treatment was assessed. The patientswere divided into the adequate dialysis group(Kt/V no less than 1.2,n=70)and the inadequate dialysis group(Kt/V lessthan 1.2,n=50)according to the Kt/V value. The baseline data,serum Ca,P,PTH,Kt/V value of the two groups werecompared,and the correlations of serum Ca,P,PTH and Kt/V values were analyzed in MHD patients. Results The age[(46.18±4.75)years old],weekly dialysis time[(13.70±1.39)h],and dry weight[(52.18±5.36)kg]in the adequate dialysisgroup were lower or shorter than those in the inadequate dialysis group while the hemoglobin(79.25±8.10)g/L and residualglomerular filtration rate(GFR)[(2.88±0.29)mL/min(1.73 m2)]were higher than those in the inadequate dialysis group(P<0.05). The serum Ca[(1.90±0.21)mmol/L],P[(2.08±0.09)mmol/L]and PTH[(245.18±24.55)pg/mL]levels werelower in the adequate dialysis group than those in the inadequate dialysis group. After adjusting for age,weekly dialysistime,dry weight,and GFR,multivariate logistic regression analysis showed that hemodialysis adequacy in MHD patientshad a certain correlation with the serum Ca,P and PTH levels(P<0.05). Spearman correlation analysis showed that serumCa,P and PTH levels were negatively correlated with Kt/V value in MHD patients(r=-0.328,-0.399,-0.294,P<0.05).Conclusion There is a certain correlation between the serum levels of Ca,P and PTH and the dialysis adequacy in MHDpatients;the MHD patients need to improve the dialysis adequacy and the serum Ca,P and PTH levels should be closelymonitored during treatment.更多还原