维持性血液透析患者血清钙、磷及甲状旁腺激素水平的横断面调查

Cross-sectional survey on serum calcium,phosphorus and PTH level in maintained hemodialysis patients

目的调查我院维持性血液透析(血透)患者中钙磷代谢紊乱及继发性甲状旁腺功能亢进症的发生情况。方法以182例血透患者作为调查对象,所有患者透析龄>3个月。采用放射免疫法检测患者透前全段甲状旁腺激素(iPTH)水平。对iPTH与血钙、血磷、血清白蛋白浓度、透析龄及透析频率等指标的相关性进行多元逐步回归分析。结果 182例调查对象血清钙浓度达标91例(50.0%),血磷浓度达标49例(26.9%),钙磷乘积达标70例(38.5%),iPTH浓度达标41例(22.5%),仅有29例(15.9%)的患者所有指标均达到控制目标值。多元逐步回归分析显示,iPTH与残余尿量和透析龄相关。结论维持性血透患者钙磷代谢紊乱及继发性甲状旁腺功能亢进治疗达标率仍较低。

Objective To investigate the condition of calcium and phosphorus disturbance and secondary hyperparathyroidism in maintained hemodialysis（HD） patients with chronic kidney disease（CKD）.Methods 182 maintained HD patients were selected.The dialysis period of all patients were longer than 3 months.The fasting serum iPTH levels of patients were measured by radioimmunoassay.The relationships between iPTH and serum calcium,serum phosphorus,serum albumin,dialysis frequency,and dialysis age were analyzed by multivariable logistic regression analysis.Results The levels of serum calcium and phosphorus fell within the range recommended 50% and 26.9% respectively.PTH levels were within the recommended values in 22.5% of the determinations.38.5% of the determinations for the calcium-phosphorus product was 55 mg2/dl2.Only 15.9% of the determinations met all four criteria.Multivariable regression analysis showed that there were correlation between iPTH and dialysis age,residual urine volume.Conclusion Calcium-phosphorus disturbance and secondary hyperparathyroidism in maintenance hemodialysis patients didn＇t be controlled well.