【摘要】 目的 探讨肾结石合并肾功能不全患者血清钙磷浓度变化以及分析钙磷比值与肾功能指标的相关性。方法 纳入2021年1月至2022年1月我院确诊为肾结石的245例患者，其中143例肾功能不全患者，102例肾功能正常的患者比较两组的临床资料[体质指数(BMI)、糖尿病史、高血压史、血糖(GLU)、糖化血红蛋白(HbA1c)、肌酐、估计肾小球滤过率(eGFR)、尿素(Urea)、尿酸(UA)、钙(Ca)、磷(P)、甲状旁腺激素(PTH)、钙磷比值(Ca/P)];评估Ca/P比值在相关代谢疾病中的影响；采用多因素逻辑回归分析肾结石患者伴肾功能不全的危险因素；采用Pearson相关分析肾结石患者血清Ca/P比值与血清肾功能指标的相关性。结果 肾功能正常患者Ca/P比值水平高于合并肾功能不全的肾结石患者，差异有统计学意义(P<0.05);肾功能正常组和肾功能不全组年龄、BMI、GLU、HbA1c、PTH、Ca、P比较，差异无统计学意义(P>0.05)。肾功能不全组的Cr、Urea和UA水平均高于肾功能正常组，eGFR水平低于肾功能正常组，差异有统计学意义(P<0.05);与正常血压的肾结石患者相比，高血压患者的Ca/P比值的中位数水平更高(P<0.05),但高血压的发生率与Ca/P比值四分位数水平无关；多因素逻辑回归分析显示，低水平的Ca/P是肾结石伴肾功能不全的危险因素(P<0.001)。血清Ca/P比值水平和Urea、Cr、UA均呈负相关(r=-0.667、-0.762、-0.258,P<0.01),与eGFR呈高度的正相关(r=0.833,P<0.01)。结论 肾结石合并肾功能不全患者Ca/P比值水平降低，且该指标和肾功能相关指标密切相关。更多还原

【Abstract】 Objective To analyze the correlation of serum calcium/phosphorus ratio level with renal function indexes in patients with kidney stone complicated with kidney disease.Methods A total of 245 patients diagnosed with kidney stone in our hospital from 2021 to 2022 were enrolled, 143 patients with kidney stone combined with kidney disease, and 102 patients with kidney stone with normal renal function were selected as the control group.Clinical data of the two groups [body mass index(BMI),history of diabetes, history of hypertension, blood glucose(GLU),glycosylated hemoglobin(HbA1c),creatinine, estimated glomerular filtration rate(eGFR),urea(Urea),uric acid(UA),calcium(Ca),phosphorus(P),parathyroid hormone(PTH),calcium-phosphorus ratio(Ca/P) ]were compared.The effect of calcium-phosphorus ratio in related metabolic diseases was evaluated.Multivariate Logistic regression was used to analyze the risk factors of kidney stone in patients with kidney disease.Pearson correlation analysis was used to analyze the correlation between serum calcium-phosphorus ratio and serum renal function indexes in patients.Results The Ca/P ratio level of patients with kidney stone was significantly higher than that of patients with kidney disease(P<0.05),while there was no significant differences in age, BMI,GLU,HbA1c, PTH,Ca and P between the two groups(P>0.05).The levels of Cr, Urea and UA in the group with kidney disease were higher than those in the normal group, and the level of eGFR was lower than that in the group with normal renal function, and the difference was statistically significant(P<0.05).Compared to kidney stone patients with normotensive, the median level of Ca/P ratio was higher in hypertensive patients(P<0.05),the median level of Ca/P ratio was higher in hypertensive patients(P<0.05),but the prevalence of hypertension was not related to the quartile level of Ca/P ratio.Multivariate logistic regression analysis showed that low level of Ca/P was a risk factor for kidney stone with kidney disease(P<0.001).The serum Ca/P ratio level was negatively correlated with Urea, Cr and UA(r=-0.667,-0.762,-0.258,P<0.01),while positively correlated with eGFR(r=0.833,P<0.01).Conclusion The Ca/P ratio level is decreased in patients with kidney stone combined with kidney disease, and closely related to renal function-related indicators.更多还原