62例维持性血液透析患者矿物质、骨代谢紊乱发生情况及危险因素调查分析

Investigation and analysis of mineral and bone metabolic disorders and risk factors in 62 maintenance hemodialysis patients

目的 总结62例维持性血液透析患者矿物质及骨代谢紊乱(CKD-MBD)发生情况,分析其危险因素.方法 回顾性分析奉新县人民医院收治的维持性血液透析患者临床资料,基于特定时间段内(2019年1月-2021年12月)选取62例作为实验对象,采用横断面研究方法调查其矿物质、骨质代谢紊乱情况,并分析年龄、性别、体重指数、肾功能等指标对患者矿物质与骨代谢紊乱的影响.结果 62例患者中有29例患者血钙达标,达标率为46.77%,有20例患者血磷达标,达标率为32.26%,有40例患者钙磷乘积达标,达标率为64.52%,有27例患者iPTH达标,达标率为43.55%,上述指标均达标者仅有11例,达标率为17.74%;达标组高血压发生率、体重指数、尿素氮(BUN)、肌酐(Scr)、尿酸(UA)显著低于未达标组(P<0.05),血红蛋白(Hb)显著高于未达标组(P<0.05);高血压、体重指数、Hb、BUN、UA、SCr均可作为维持性血液透析患者矿物质、骨代谢紊乱的独立危险因素.结论 血透治疗患者CKD-MBD发生因素复杂,高血压、钙磷乘积、iPTH、糖尿病等均是诱发CKD-MBD的独立危险因素,临床需依据危险因素提前采取相应的预防措施,确保血透治疗的安全性.

Objective To summarize the occurrence of mineral and bone metabolic disorder(CKD-MBD)in 62 maintenance hemodialysis patients and analyze its risk factors.Methods The clinical data of maintenance hemodialysis patients admitted to our hospital were retrospectively analyzed.Based on a-pecific period of time(January 2019-December 2021),62 patients were selected as experimental subjects.The cross-sectional study method was used to investigate their mineral and bone metabolism disorders,and the effects of age,gender,body mass index,renal function and other indicators on the mineral and bone metabolism disorders of patients were analyzed.Results Among the 62 patients,29 palients reached the standard of blood calcium,the standard rate was 46.77%,20 patients reached the standard of blood phosphorus,the standard rate was 32.26%,40 patients reached the standard of calcium phosphorus product,the standard rate was 64.52%,27 patients reached the slandard of iPTH,the standard rate was 43.55%,and only 11 patients reached the standard,the standard rate was 17.74%;the incidence of hypertension,body mass index,urea nitrogen(BUN)creatinine(SCR)and uric acid(UA)in the standard group were significantly lower than those in the non standard group(P<0.05),and hemoglobin(HB)was significantly higher than those in the non standard group(P<0.05);Hypertension,body mass index,Hh,bun,UA and SCR can be regarded as independent risk factors for mineral and bone metabolism disorders in mainlenance hemodialysis palients.Conc lus ion The risk factors of CKD-MBD in hemodialysis patients are complex.Hypertension,calcium phosphorus product.iPTH,diabeles are all independent risk factors for inducing CKDMBD.Corresponding preventive measures should be taken in advance according to the risk factors to ensure the safety of hemodialysis treatment.