维持性血液透析患者骨代谢指标变化及相关分析

Clinical Analysis of Index of Bone Metabolism Changes in Maintained Hemodialysis Patients

目的调查维持性血液透析患者中钙、磷及血清全段甲状旁腺激素(iPTH)水平的差异。方法以98例透析龄>3月的血液透析患者作为调查对象,根据患者透析龄的长短将患者分为透析龄<12月组、12月<透析龄<36月组以及透析龄≥36月组;生物化学仪分析各组间血钙、血磷、血肌酐、尿素氮等,采用ELISA法检测患者透析前iPTH水平。结果血液透析患者随透析龄延长iPTH水平逐步升高(P<0.05);在短透析龄(透析龄<36月)患者中糖尿病患者iPTH水平低于非糖尿病者,差异具有显著性(P<0.05);回归分析显示,iPTH与血磷和透析龄相关。结论长期血液透析患者iPTH水平随透析龄延长而升高且与高血磷相关。

Aim To investigate the levels of calcium and phosphorus disturbance and intact parathyroid hormone （iPTH） in maintained hemodialysis（HD） patients. Methods The study included 98 patients,who were on haemodialysis treatment for 3～192 months. Patients in a group were subdivided into dialysis age 〈12 months group and 12 months〈dialysis age 〈36 months group and dialysis age ≥36 months group. iPTH level and clinical data were compared among the groups. Results Serum iPTH was significantly higher in dialysis age ≥36 months group than that in dialysis age 〈12 months group and 12 months〈dialysis age 〈36 months group（P〈0.05）. iPTH level was significantly lower in diabetic patients with short dialysis age（dialysis age 〈36 months） than that in nondiabetic patients （P〈0.05）.