维持性非卧床腹膜透析患者血清镁与血管钙化及矿物质代谢的关系

Relationship between serum magnesium level with vascular calcification and mineral disorder in patients on continuous ambulatory peritoneal dialysis

目的 探讨维持性非卧床腹膜透析患者血清镁水平与腹主动脉钙化及矿物质代谢紊乱的关系.方法 纳入来自2016年1月至2017年1月青岛市市立医院腹透中心慢性维持性腹膜透析患者62例,采用腹部侧位片检查腹主动脉钙化情况,计算腹主动脉钙化积分（AACs）;根据腹主动脉钙化情况将患者分为A组（AACs≤4分）,B组（〉4分~≤15分）和C组（AACs〉15分）.并收集患者的临床资料和血生化指标.观察3组患者血清镁浓度,并探讨血清镁与全段甲状旁腺激素、血钙、血磷的关系.结果 62例维持性非卧床腹膜透析患者41例存在血管钙化,其发生率为66.13%.A、B、C组血清镁浓度分别为（1.00±0.18）、（0.89±0.10）、0.75±0.13） mmol/L,3组间均数差异有统计学意义（F=11.99,P〈0.05）,且A组较B组、C组明显升高,差异均有统计学意义（P均〈0.05）,B组较C组明显升高,差异有统计学意义（P〈0.05）.血清镁浓度与甲状旁腺激素（r=-0.288,P〈0.05）、血磷（r=-0.272,P〈0.05）、AACs（r=-0.610,P〈0.01）呈负相关;与血钙无相关性（r=0.174,P〉0.05）.结论 血管钙化是维持性非卧床腹膜透析患者常见并发症,血清镁浓度与腹主动脉钙化、甲状旁腺激素、血磷有一定的相关性.

Objective To explore the relationship between serum magnesium level,abdominal aortic calcification（AAC） and mineral metabolism in continuous ambulatory peritoneal dialysispatients.Methods Sixty-two cases patients who were on Continuous Ambulatory Peritoneal Dialysis in Pritoneal Dialysis Center of Qingdao Municipal Hospital were enrolled prospectively.The AAC was detected by abdomen lateral plain radiographs,and the AAC score（AACs） was calculated.According to the AACs,the patients were divided into group A（AACs≤4 points） and group B（from 〉4 point to ≤15 point） and group C（AACs〉15 point）.And collected the patient′s clinical data and blood biochemical indicators.The serum magnesium levels of 3 groups were observed,and explored the relationship of serum magnesium and intact parathyroid hormone（iPTH）,serum calcium,serum phosphorus.Results There were 41 cases of vascular calcification in 62 cases maintenance ambulatory peritoneal dialysis patients,and its incidence was 66.13%.Group levels of serum magnesium were in group A was （1.00±0.18） mmol/L,（0.89±0.10） mmol/L of group B,and （0.75±0.13） mmol/L of group C,the mean differences were significant（F=11.99,P〈0.05）,and the group A was significantly higher than the group B and C,the differences were significant（P〈0.05）,the group B was significantly higher than the group C,the difference was significant（P〈0.05）.There was negatively correlation between serum magnesium and iPTH（r=-0.288,P〈0.05）,serum phosphorus（r=-0.272,P〈0.05） and AACs（r=-0.610,P〈0.01）.While there was no significant correlation of serum calcium（r=0.174,P〉0.05）.Conclusion Vascular is the calcification frequent complications in continuous ambulatory peritoneal dialysis patients.The serum level of serum magnesium may be correlated with the AAC,iPTH,serum phosphorus.