腹膜透析患者钙磷代谢与颈动脉钙化相关性临床研究

Clinical analysis on correlation between the calcium-phosphorus metabolism and carotid artery calcification in peritoneal dialysis patients

目的观察钙磷代谢紊乱与颈动脉钙化的关系,探讨持续性非卧床腹膜透析(CAPD)患者颈动脉钙化的危险因素及防治。方法将68例CAPD患者根据透析剂量及颈动脉钙化程度分组,观察颈动脉钙化与血钙、血磷等各生化指标的关系。采用彩色多普勒超声诊断仪观察腹透患者颈动脉钙化程度。结果 68例CAPD患者中不同程度颈动脉钙化者51例(75.0%),随着透析时间的延长,腹膜透析患者颈动脉钙化程度增加(P<0.01);钙化组血磷、钙磷乘积、C反应蛋白较无钙化组显著增高,而血浆白蛋白较无钙化组显著降低(P<0.05或P<0.01)。结论腹膜透析患者中存在不同程度颈动脉钙化,其钙化程度与营养状态、透析时间相关,患者高磷血症、钙磷乘积升高、炎症状态、低白蛋白水平是颈动脉钙化的重要危险因素。

Objective To observe the relevant factor of carotid artery calcification and calcium-phosphorus metabolism and investigate the prevention and treatment of calcium-phosphorus metabolism to carotid artery calcification in patients undergoing continuous ambulatory peritoneal dialysis （CAPD）. Methods 68 patients with peritoneal dialysis were divided into different groups according the dose of peritoneal dialysate exchanged everyday and the different level of carotid artery calcification. Meanwhile the relationships between carotid artery calcification and calcium, phosphate, and so on were analyzed. Results In total 68 patients with CAPD, ca- rotid calcification was confirmed in 51 patients （75 % ）. The longer peritoneal dialysis time, the more severer carotid artery calcifi- cation （P 〈 0.01 ）. Patients with carotid artery calcification had higher serum phosphate level, calcium-phosphorus product, CRP level and lower serum albumin than those patients without carotid calcification （ P 〈 0.05 or 0.01 ）. Conclusion Carotid artery calcification with different levels are existed in CAPI） patients. The nutritional status and the peritoneal dialysis time correlate with carotid artery calcification closely. The higher serum phosphate level, calcium-phosphorus product, CRP level and lower serum albumin are main influential factors of carotid artery calcification. They are the important dangerous factors to carotid artery calcification.