维持性血液透析患者发生相对性甲状旁腺功能减退的危险因素分析

Risk Factors for Relative Hypoparathyroidism in Maintenance Hemodialysis Patients

目的:分析维持性血液透析(MHD)患者发生相对性甲状旁腺功能减退(SRHOP)的危险因素。方法:选取2018年1月-2019年8月在北海市人民医院接受治疗的透析时间3个月以上且病情稳定的116例MHD患者作为研究对象。检测全段甲状旁腺激素(iPTH),根据PTH浓度分为SRHOP组(n=42)和非SRHOP组(n=74)。进行单因素分析和多因素Logistic回归分析患者发生SRHOP的危险因素。结果:两组年龄、原发疾病为糖尿病、透析龄、ALB、AKP、血钙、钙磷乘积比较,差异均有统计学意义(P<0.05)。多因素Logistic回归显示,年龄≥60岁、原发疾病为糖尿病、透析龄长、ALB水平低、AKP水平低、血钙水平高是MHD患者发生SRHOP的危险因素。结论:年龄≥60岁、透析龄长、原发疾病为糖尿病、ALB水平低、AKP水平低、血钙水平高均可导致MHD患者SRHOP的发生,合并上述危险因素的患者应定期监测并干预,以提高患者预后。

Objective:To analyze the risk factors for relative hypoparathyroidism(SRHOP)in maintenance hemodialysis(MHD)patients.Method:A total of 116 MHD patients with stable condition and dialysis treatment for more than 3 months who were treated in Beihai People’s Hospital from January 2018 to August 2019 were selected as the research objects.The whole parathyroid hormone(iPTH)was detected.According to the PTH concentration,they were divided into the SRHOP group(n=42)and the non-SRHOP group(n=74).Univariate analysis and multivariate logistic regression were performed to analyze the risk factors for patients with SRHOP.Result:There were statistically significant differences between the two groups in age,diabetes as the primary disease,dialysis age,ALB,AKP,blood calcium,calcium and phosphorus product comparison(P<0.05).Multivariate Logistic regression showed that age≥60 years old,diabetes as the primary disease,long dialysis age,low ALB level,low AKP level and high blood calcium level were the risk factors of SRHOP occurrence in patients with MHD.Conclusion:Age≥60 years,long dialysis age,diabetes as the primary disease,low ALB level,low AKP level and high blood calcium level can all lead to the occurrence of SRHOP in MHD patients.Patients with the above-mentioned risk factors should be monitored and intervened regularly to improve the prognosis.