透析患者钙磷代谢紊乱的相关因素分析

Analysis of Related Factors of Calcium and Phosphorus Metabolism Disorders in Dialysis Patients

目的分析透析患者钙磷代谢紊乱的相关因素。方法选取本院收治的100例维持性血液透析慢性肾衰竭患者作为研究对象。所有患者透析时间均>3个月,且病情均稳定。根据患者不同年龄段分为非老年组(<60岁)和老年组(≥60岁),各50例。透析前检测指标包括白蛋白(Alb)、磷(P)、钙(Ca)、血红蛋白(Hb)、全段甲状旁腺激素(i PTH)、血清肌酐(Scr)、尿素氮(BUN)等,透析后测定血清BUN浓度,记录超滤量和体质量,根据公式对标准蛋白氮呈现率(n PNA)、尿素清除指数(Kt/V)、血清白蛋白校正钙(Ac-Ca)等进行计算。结果老年组Alb、i PTH、P、Scr等指标浓度与非老年组比较,差异有统计学意义(P<0.05);两组平均动脉压、n PNA、Kt/V、Ac-Ca、Hb等指标比较差异无统计学意义(P>0.05)。Logistic回归分析显示,老年组钙磷乘积≤55 mg^2/d L^2与白蛋白、校正钙等存在较强相关性。结论在透析患者中,老年患者多数具有钙磷代谢紊乱,而影响老年透析患者钙磷代谢紊乱的主要因素为白蛋白、校正钙。

Objective To analyze the related factors of calcium and phosphorus metabolism in dialysis patients. Methods A total of 100 patients with maintenance hemodialysis chronic renal failure treated in our hospital were selected.All clinical data were retrospectively analyzed.The dialysis time of all patients was >3 months and the disease was stable.According to different age groups of patients,they were divided into non-elderly group(<60 years)and elderly group(≥60 years),with 50 cases in each group.The pre-dialysis detection indexes include albumin(Alb),phosphorus(P),calcium(Ca),hemoglobin(Hb),whole-segment parathyroid hormone(i PTH),serum creatinine(Scr),urea nitrogen(BUN),etc.After dialysis,the BUN concentration of serum was measured,the ultrafiltration amount and body quality were recorded. The nitrogen expression rate(n PNA),urea clearance index(Kt/V)and serum albumin corrected calcium(Ac-Ca)were calculated according to the formula.Results The concentrations of Alb,i PTH,P,and Scr in the elderly group were significantly lower than those in the non-elderly group,and there was a significant difference between the two groups(P<0.05).The mean arterial pressure,n PNA,Kt/V,and Ac-Ca were not significantly different in the two groups(P>0.05).Logistic regression analysis showed that there was a strong correlation between the calcium-phosphorus product≤55 mg2/dl2 and albumin and calcium correction in the elderly group. Conclusion Among the dialysis patients,most of the elderly patients have calcium and phosphorus metabolism disorders,but the main factors affecting calcium and phosphorus metabolism disorders in elderly dialysis patients are albumin and calcium correction.