黄山市血液透析患者现况调查分析

Epidemiological investigation of patients on maintenance hemodialysis survey and analysis on the status of patients on maintenance hemodialysis in Huanshan

目的了解黄山市维持性血液透析（MHD）患者的现状。方法对2015年9月在黄山市人民医院治疗、透析龄3个月以上的154例MHD患者进行现况调查,分析患者年龄、性别等分布情况,检测、记录、计算患者透析前肌酐、透析龄、血红蛋白、血清钙、血清磷水平、钙磷乘积、全段甲状旁腺激素（i PTH）水平。结果 154例患者中,男89例（57.79%）,女65例（42.21%）,男女比例为1.37∶1;年龄≤60岁者78例,〉60岁者76例;原发病前3位分别为慢性肾小球肾炎74例（48.1%）、糖尿病肾病33例（21.4%）、高血压肾损害19例（12.3%）;Hb〈110 g/L者146例（94.81%）,Hb≥110 g/L者8例（5.19%）;血钙2.1~2.37 mmol/L者37例（24.01%）;血磷1.13~1.78 mmol/L者65例（42.21%）;钙磷代谢紊乱（高钙、低钙、高磷、低磷）139例（90.26%）,钙磷乘积〉4.52 mmol2/L2者23例（14.94%）;i PTH最低者仅2.213 ng/L,最高者达3 285.77 ng/L,〈150 ng/L者41例（26.6%）,150~600 ng/L者90例（58.4%）,〉600 ng/L者23例（14.9%）。结论维持性血液透析患者男性较女性略多,发病年龄年轻化,慢性肾小球肾炎仍是终末期肾脏病的第1位病因;MHD患者Hb达标率极低,钙磷代谢紊乱及继发性甲状旁腺功能亢进患者比较多见。

Objective To investigate the present situation of patients on maintenance hemodialysis （MHD） in Huangshan. Methods A total of 154 patients received MHD in the people~ hospital of Huangshan during September, 2015 were selected, all patients had received MHD for more than 3 months, age, gender, dialysis age, Hb, serum Ca, serum phosphate, CaxP product and serum iPTH of all patients were recorded and analyzed. Results There were 89 males （57.79%） and 65 females （42.21%）, with the male to female ratio of 1.37 ： 1 ; 78 cases of patient were younger than or equal to 60 years old and 76 patients were over 60 years old; the top three disease etiologies were chronic glomerulonephritis （74 cases, 48. 1% ）, diabetic nephropathy （33 cases, 21.4% ） ,hypertensive renal damage（ 19 cases, 12.3% ） ; Hb less than 110g/L were in 146 patients （94.81%） ,Hb≥110 g/L were in 8 patients （5.19%） ; the blood calcium of 37patients （24.01% ） was from 2.1 to 2.37 mmol/L; serum phosphate of 65 patients （42.21%） was from 1. 13 to 1.78 mmol/L; 139 patients （90. 26% ） in disorder of calcium phosphate metabolism （including hypercalcemia, hypocalcemia, hyperphosphatemia and hypophosphatemia）, the calcium-phosphorus product 〉 4.52 mmol2/L2 were in 23 patients（ 14.94% ） ; the lowest iPTH was only 2. 213 ng/L, and the highest was 3285.77ng/L, iPTH 〈 150 ng/L were in 41 patients（26.6% ）, the iPTH of 90 patients （58.4%） was 150 to 600ng/L, iPTH 〉 600 ng/L were in 23 patients （14.94%）. Conclusions MHD patients are more males than females, the uremic patients tended to be younger, chronic glomerulonephritis is the first pathogeny of ERSD; MHD patients has low standard-reaching rate of Hb, disorder of calcium phosphate metabolism and secondary hyperparathyroidism are found more.