尿毒症患者颈动脉钙化与钙磷代谢的临床分析

Clinical Analysis of Relationship between Carotid Artery Calcification and Calcium Phosphorus Metabolism Disorder in Patients with Uremia

目的研究终末期肾病(ESRD)患者颈动脉钙化情况与钙磷代谢紊乱的关系。方法对43例ESRD患者应用彩色B型超声仪观测双侧颈动脉内膜-中膜厚度(IMT)及钙化情况,同时抽血检测血钙、磷、血胆固醇、甘油三酯、二氧化碳结合力、血肌酐,并计算钙磷乘积。结果43例ESRD患者24例(55.8%)存在颈动脉钙化。钙化组IMT值、血磷及钙磷乘积较无钙化组显著增高(分别P<0.01、P<0.05、P<0.05),高血磷组二氧化碳结合力水平较血磷不高组明显降低(P<0.05)。结论ESRD患者存在较高的颈动脉钙化率。颈动脉钙化与颈动脉IMT值、血磷、钙磷乘积增高密切相关,血磷与血CO2含量呈负相关,应重视纠正钙磷代谢紊乱和代谢性酸中毒。

Objective To investigate the relationship between carotid artery calcification and calcium phosphorus metabolism disorder in patients with end stage renal disease（ESRD）. Methods The intima-media thickness（IMT） and calcification degree of bilateral carotid artery were detected by uhrasonography in 43 patients with ESRD and serum calcium/phosphorus, serum lipid profile,creatinine,CO2CP were checked at the same time. Results Carotid calcification was confirmed in 24 of 43 cases with ESRD（55.8% ）. IMT,serum phosphorus and calcium phosphorus product were significantly higher（ P 〈 0.01, P 〈 0.05, P 〈 0.05 respectively） in patients with carotid calcification than those in patients without carotid calcification. Higher concentration of serum phosphorus was associated with lower CO2CP（P 〈 0.05 ）. Conclusion Carotid calcification was very prevalent in ESRD patients. IMT, serum phosphorus and calcium phosphorus product were closely correlated with carotid calcification in such patients and negative relationship was found between serum phosphorus concentration and CO2CP. To correct the calcium phosphorus disorder and metabolic acidosis is important.