血液透析患者25羟维生素D水平及其与骨密度关系的研究

The relationship between mineral density and levels of 25-hydroxyvitamin D in hemodialysis patients

目的:探讨我科长期规律血液透析患者血清25羟维生素D水平变化及其与骨密度的关系。方法:选取广仁医院血液净化中心2015年1月至10月规律血液透析患者90例,分为糖尿病肾病透析组和非糖尿病肾病透析组,分别检测血清25羟维生素D、甲状旁腺素(PTH)、血钙、血磷等指标,测定其骨密度值,并分析两组间各指标的差异及25羟维生素D水平与骨密度值之间的关系。结果:两组骨密度值及25羟维生素D水平均下降,且糖尿病肾病透析组骨密度与血清25羟维生素D水平明显低于非糖尿病肾病透析组(P<0.05),两组血钙、血磷水平差异无统计学意义(P>0.05)。相关性分析显示透析患者骨密度值与25羟维生素D水平呈线性正相关关系(P<0.05)。结论:我科长期血液透析患者均出现骨质代谢紊乱,骨密度及25羟维生素D水平在糖尿病肾病透析患者中更低。

Objective： To investigate the relationship between the serum 25-hydroxyvitamin D levels and bone mineral density with long-term regular hemodialysis patients in our department. Methods： 90 cases of hemodialysis patients from January to October in 2015 of the Blood Purification Center of the GuangRen Hospital were divided into diabetic nephropathy dialysis group and non-diabetic nephropathy dialysis group,serum 25-hydroxyvitamin D,PTH,calcium,blood phosphorus and other indicators were detected,bone mineral density was measured. The difference of each index of the two groups,and the relationship of 25-hydroxy vitamin D levels and bone mineral density values were analyzed. Results： Bone mineral density values and 25-hydroxy vitamin D levels of the two groups were decreased,and the bone mineral density and 25-hydroxyvitamin D levels of the diabetic nephropathy dialysis group were significantly lower than those of non-diabetic nephropathy dialysis group（ P〈0. 05）,serum calcium,phosphorus levels had no statistically significant difference between the two groups（ P〉0. 05）.Correlation analysis showed that bone mineral density and 25-hydroxyvitamin D levels of dialysis patients were linear correlation（ P〈0. 05）. Conclusion： ALL of the dialysis patients in our department must be appear bone metabolic disorders,and the bone density and 25-hydroxy vitamin D levels are lower in diabetic dialysis patients.