25羟维生素D3在维持性血液透析患者中的水平及相关因素分析

25-hydroxy vitamin D_(3) levels and related factors among maintenance hemodialysis patients

目的分析维持性血液透析(maintenance hemodialysis,MHD)患者25羟维生素D3[25 hydroxy vitamin D,25(OH)D3]水平及相关影响因素。方法选取2017年1月—2019年1月在空军特色医学中心血液净化中心接受血液透析治疗的尿毒症患者90例,根据其25(OH)D3水平分为25(OH)D3低下组(缺乏+不足)、正常组,并化验血红蛋白(hemoglobin,Hb)、血磷(P)、血钙(Ca)、全段甲状旁腺激素(intact parathyroid hormone,iPTH)、血白蛋白(albumin,Alb)、血清碱性磷酸酶(serum alkaline phosphatase,ALP)、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、高密度脂蛋白(high density lipoprotein,HDL)、低密度脂蛋白(low density lipoprotein,LDL)等指标。结果本组患者共发生25(OH)D3水平低下64例,发生率71.1%(64/90)。25(OH)D3低下组在身高、性别、Hb、TG、HDL水平与正常组差异有统计学意义(P<0.05);Pearson相关分析表明,身高、Hb、HDL与25(OH)D3水平相关;多因素回归分析表明显示,Hb、HDL是影响维持性血液透析患者25(OH)D3水平的独立影响因素。结论维持性血液透析患者存在25(OH)D3水平低下,Hb、HDL对维持性血液透析患者25(OH)D3水平发挥重要作用。

Objective To analyze the level of 25 hydroxy vitamin D3[25 hydroxy vitamin D,25(OH)D3] and related factors in maintenance hemodialysis(MHD) patients.Methods Between January 2017 and January 2019,90 uremic patients received hemodialysis in the Blood Purification Center of Air Force Medical Center.According to their 25(OH)D3 levels,they were divided into the low vitamin D group(deficiency group+insufficient group) and the normal group.Levels of hemoglobin(Hb),blood phosphorus(P),blood calcium(Ca),intact parathyroid hormone(iPTH),albumin(Alb),serum alkaline phosphatase(ALP),total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL) and low density lipoprotein(LDL) were detected.Results A total of 64 patients with low levels of 25(OH)D3 were detected,so the incidence rate was 71.1%(64/90).There was statistically significant difference in height,gender,Hb,TG and HDL between the low vitamin D group and the normal group(P<0.05).Pearson correlation analysis showed that height,Hb and HDL were correlated with 25(OH)D3 levels,while multivariate regression analysis suggested that Hb and HDL were independent influencing factors of 25(OH)D3 levels in maintenance hemodialysis patients.Conclusion 25(OH)D3 deficiency is common in maintenance hemodialysis patients.Hb and HDL are critical to the level of 25(OH)D3 in these patients.