慢性肾衰竭患者的肾性贫血同血脂和钙磷代谢之间的相关性研究

Investigation on the correlations between renal anemia and blood lipid metabolism and between renal anemia and calcium-phosphorus metabolism in patients with CRF

目的:对慢性肾衰竭(CRF)患者肾性贫血同血脂和钙磷代谢之间的相关性进行探讨。方法:回顾性分析医院收治的108例慢性肾衰竭患者,按照是否发生肾性贫血将其分为贫血组(81例)和无贫血组(27例);在81例贫血组患者按照血红蛋白(Hb)水平再分为轻度组(34例,Hb>900 g/L)、中度组(31例,Hb为60~90 g/L)及重度组(16例,Hb<60 g/L),对比各组患者的尿素氮(BUN)、肌酐(Cr)、甲状旁腺素(PTH)、血脂指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]以及钙磷代谢指标水平,同时利用SAS软件逐步回归方法对肾性贫血同血脂和钙磷代谢之间的相关性进行分析。结果:贫血组中轻度、中度及重度3组患者分别与无贫血组相比,BUN、Cr、PTH、Hb、HDL-C以及LDL-C水平较高,差异有统计学意义(F=7.547,F=12.578,F=10.663,F=8.745,F=4.223,F=5.178;P<0.05)。利用SAS软件逐步回归方法对肾性贫血同各个指标分析时可见,血Hb分别与TC、HDL-C之间存在着明显的正相关性(r=0.564,r=0.881;P<0.05),与BUN、Cr、磷、PTH及LDL-C之间存在着明显的负相关性(r=-0.661,r=-0.437,r=-0.541,r=-0.489,r=-0.402;P<0.05)。结论:CRF患者肾性贫血的发生与磷代谢紊乱、血脂及继发性甲状旁腺功能亢进具有直接的相关性。BUN、Cr及PTH水平较高,Hb水平较低,且随着贫血程度的加重以上指标改变的更加显著。

Objective:To explore the correlation between renal anemia and blood lipid metabolism and between renal anemia and calcium-phosphorus metabolism in patients with chronic renal failure(CRF).Methods:A retrospective analysis was performed on 108 patients with CRF admitted to our hospital.According to the occurrence of renal anemia,they were divided into the anemia group(n=81)and the anemia-free group(n=27).The anemia group was further divided into the mild group(n=34,Hb value>90g/L),the moderate group(n=31,Hb value was between 60 and 90 g/L)and the severe group(n=16,Hb value<60g/L)according to different ranges of their hemoglobin levels.The series of levels included the urea nitrogen(BUN),creatinine(Cr),parathyroid hormone(PTH),blood lipids index[total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)]and calcium-phosphorus metabolism index[calcium(Ca),phosphorus(P)]among different groups were compared.At the same time,the stepwise regression method of SAS software was used to analyze the correlations between renal anemia and blood lipid metabolism and between renal anemia and calcium-phosphorus metabolism.Results:Compared with the anemia-free group,BUN,Cr and PTH levels of mild,moderate and severe group of anemia group were higher,and Hb,HDL-C and LDL-C levels of them were higher,and the changes above indicators were more significant with the aggravating of the anemia degree,the differences of them among different groups were statistically significant(F=7.547,F=12.578,F=10.663,F=8.745,F=4.587,F=4.223,F=5.178,F=8.447,P<0.05).The analytic results of stepwise regression of SAS software for renal anemia and various indicators indicated that there were positive correlations between blood Hb and TC and between blood Hb and HDL-C(r=0.564,r=0.881,P<0.05),and there were negative correlations between blood Hb and BUN,between blood Hb and Cr,between blood Hb and phosphorus,and between blood Hb and PTH,and between blood Hb and LDL-C(r=-0.661,r=-0.437,r=-0.541,r=-0.489,r=-0.402,P<0.05).Conclusion:The occurrence of renal anemia in CRF patients is directly correlated with phosphorus metabolism disorder,blood lipid and secondary hyperparathyroidism.And the levels of BUN,Cr and PTH were higher,and Hb level was lower,and the changes above indicators were more significant with aggravating of anemia degree,and the differences of them among different groups were significant.