不同腹膜转运特性对血钙、血磷及PTH的影响

Peritoneal transport status affects On serum calcium, phosphorus and parathyroid hormone

目的研究无尿持续非卧床腹膜透析（CAPD）患者腹膜转运功能对骨矿物质代谢的影响。方法选择159例无尿CAPD患者，根据腹膜平衡试验将患者分为2组：低转运特性组87例，高转运特性组72例。检测两组患者血钙、血磷、甲状旁腺激素等生化指标，测定腹膜尿素清除指数（KT／V）及肌酐清除率（CCr）。结果与低转运特性患者相比，高转运特性患者血钙、血磷和甲状旁腺激素水平明显偏低，而KT／V、CCr偏高，差异有统计学意义（P〈0．05）。多元逐步回归分析显示，CCr与血钙、血磷呈负相关（P〈0．05），Kt／V与血钙呈负相关关系（P〈0．05），而D／Pcr与血钙、血磷、甲状旁腺激素无明显相关性。结论低腹膜转运特性患者易出现高磷血症和高甲状旁腺激素；腹摸转运特性能影响血钙、血磷、甲状旁腺激素水平，但之间未见显著相关性。

Objective To explore the relationship between the characteristic of peritoneal trans- port and mineral and bone disorder on patients treated with Continuous Ambulatory Peritoneal Dialysis （CAPD）. Methods 159 anuria patients divided to high transport status （D/Pcr≥0. 65,H） and low transport status （D/Pcr 〈0. 65, L）. Calcium （Ca）, phosphorus （P）, serum parathyroid hormone （PTH）, index of Kt/V and CCr were measured. Results Compare to L group, Ca, P and PTH were lower in H group, whereas index of Kt/V and CCr were higher in H group（P〈0. 05）. Multiple linear stepwise regression analysis revealed negative correlations between CCr and Ca, P, negative correla- tions between Kt/V and Ca, there were no relationship between D/Pcr and Ca, P and PTH （P〈 0. 05）. Conclusions Patients with low transport status prone to show hyperphosphatemia and hyper- parathyroidism, Peritoneal membrane transport category affects Ca, P and iPTH, but there are no re lationship between D/Pcr and Ca, P and PTH.