维持性血液透析患者钙磷代谢异常危险因素与干预措施分析

Analysis of risk factors and intervention measures of abnormal calcium and phosphorus metabolism in maintenance hemodialysis patients

目的分析维持性血液透析患者钙磷代谢异常危险因素,为实施有效的干预措施提供参考。方法选取2019年1月—2020年3月于惠东县人民医院行维持性血液透析的终末期肾病患者100例,收集所有患者的临床资料,采用多因素Logistic回归分析维持性血液透析患者钙磷代谢异常危险因素。结果 100例患者中经维持性血液透析治疗,6个月各指标均达标64例,非达标36例,达标率为64.00%。将所有患者分为达标组64例及非达标组36例。2组性别、透析频率、舒张压、收缩压、血红蛋白、白蛋白、血磷、血甲状旁腺激素(iPTH)、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇比较,差异无统计学意义(P>0.05)。达标组年龄小于非达标组,透析时间短于非达标组,血液透析治疗期间规律服用铁剂、使用促红细胞生成素、规律服用骨化三醇率,血钙水平高于非达标组(P<0.05)。多因素Logistic回归分析显示,患者年龄、透析时间、血液透析治疗期间规律服用铁剂、使用促红细胞生成素、规律服用骨化三醇、血钙水平是影响维持性血液透析患者钙磷代谢异常的独立影响因素(P<0.05,OR>1)。结论年龄、透析时间、血液透析治疗期间规律服用铁剂、使用促红细胞生成素、规律服用骨化三醇、血钙水平是影响维持性血液透析患者钙磷代谢异常的主要因素,在临床干预中需予以重视。

Objective To analyze the risk factors of abnormal calcium and phosphorus metabolism in maintenance hemodialysis patients,and to provide reference for the implementation of effective intervention measures.Methods A total of 100 cases of patients with end-stage renal disease who were treated with maintenance hemodialysis were selected from January 2019 to March 2020 in Huidong County People’s Hospital.The clinical data of all patients were collected and the risk factors of abnormal calcium and phosphorus metabolism in maintenance hemodialysis patients were analyzed by multi factor Logistic regression.Results Among the 100 patients treated with maintenance hemodialysis,64 cases were up to the standard and 36 cases were not up to the standard after 6 months.The rate of up to standard was 64.00%.All patients were divided into standard group(64 cases)and non standard group(36 cases).There was no significant difference in gender,dialysis frequency,diastolic blood pressure,systolic blood pressure,hemoglobin,albumin,blood phosphorus,iPTH,total cholesterol,triglyceride,low density lipoprotein cholesterol and high density lipoprotein cholesterol between the two groups(P>0.05).The age of the standard group was younger than that of the non standard group,and the dialysis time was shorter than that of the non standard group.The incidence of regular iron,erythropoietin and calcitriol during hemodialysis treatment was higher than that of the non standard group(P<0.05).Multivariate Logistic regression analysis showed that age,dialysis time,regular use of iron,erythropoietin,calcitriol and serum calcium level were independent influence factors for abnormal calcium and phosphorus metabolism in maintenance hemodialysis patients(P<0.05,OR>1).Conclusion Age,dialysis time,regular iron use,erythropoietin,regular use of osteotripol and calcium levels are the main factors affecting the abnormal calcium and phosphorus metabolism in patients with maintenance hemodialysis,which should be paid attention to in clinical intervention.