慢性肾衰竭血液透析患者矿物质-骨异常的危险因素

Risk Factors of Mineral-bone Abnormalities in Hemodialysis Patients with Chronic Renal Failure

目的研究慢性肾衰竭血液透析患者矿物质-骨异常的危险因素。方法选取2019年3月-2021年3月我院收治的60例慢性肾衰竭血液透析患者,根据有无发生矿物质-骨异常分为异常组(n=32)和对照组(n=28)。统计并比较两组基础资料,包括性别、年龄、原发病、吸烟史、饮酒史、透析龄、透析频率、每次透析时间、成纤维细胞生长因子(FGF-23)、血骨钙素(BGP),利用ROC分析FGF-23、BGP水平预测慢性肾衰竭透析患者矿物质-骨异常的价值,将两组有差异信息纳入Logistic回归分析模型,明确慢性肾衰竭透析患者矿物质-骨异常的危险因素。结果经单因素分析,异常组年龄>60岁、透析龄>5年患者比例及FGF-23、BGP水平显著高于对照组,差异有统计学意义(P<0.05)。经ROC分析,FGF-23、BGP水平预测慢性肾衰竭血液透析患者矿物质-骨异常的曲线下面积为0.832、0.813。经多因素Logistic回归分析,年龄、透析龄、FGF-23、BGP水平是影响慢性肾衰竭血液透析患者矿物质-骨异常的危险因素(P<0.05)。结论当年龄>60岁、透析龄>5年、FGF-23>161.355 ng/L、BGP>125.120 ng/m L时,慢性肾衰竭血液透析患者矿物质-骨异常的发生风险较大。

Objective:To study the risk factors of mineral-bone abnormalities in hemodialysis patients with chronic renal failure.Methods:60 hemodialysis patients with chronic renal failure admitted in our hospital from March2019 to March 2021 were selected,and were divided into abnormal group(n=32)and control group(n=28)according to whether or not mineral-bone abnormalities occurred.The basic data of the two groups were statistically compared,including gender,age,primary disease,smoking history,drinking history,dialysis age,dialysis frequency,dialysis time,fibroblast growth factor(FGF-23)and blood osteocalcin(BGP).The ROC analysis of FGF-23 and BGP levels was used to predict the value of mineral-bone abnormalities in hemodialysis patients with chronic renal failure,and the difference information between the two groups was incorporated into Logistic regression analysis model.Results:By univariate analysis,the proportion of patients with age>60 years and hemodialysis age>5 years in the abnormal group and the levels of FGF-23 and BGP were significantly higher than those in the control group(P<0.05).According to ROC analysis,the areas under the curve of FGF-23 and BGP levels for predicting mineral-bone abnormalities in hemodialysis patients with chronic renal failure are 0.832 and 0.813.Multivariate Logistic regression analysis showed that age,hemodialysis age,FGF-23 and BGP levels were the risk factors of mineral-bone abnormalities in hemodialysis patients with chronic renal failure(P<0.05).Conclusion:When the age is>60 years old,the hemodialysis age is>5years,FGF-23 is>161.355 ng/L,BGP is>125.120 ng/m L,the occurrence risk of mineral-bone abnormalities in hemodialysis patients with chronic renal failure is higher.