维持性血液透析患者代谢性骨病发生情况及相关影响因素分析

Analysis of the incidence and related influencing factors of metabolic bone disease in maintenance hemodialysis patients

目的 维持性血液透析患者代谢性骨病发生情况及相关影响因素分析。方法 回顾性选择2022年2月至2024年5月在中山大学附属第五医院接受维持性血液透析患者277例为研究对象,以描述性分析方法分析代谢性骨病发生情况,并采用单因素、Logistic回归分析方法探究相关影响代谢性骨病发生的因素。结果 代谢性骨病检出率为51.62%。经单因素分析,性别、年龄、体重指数、运动习惯、透析时间、骨痛史、营养状况、25羟维生素D状况、合并基础疾病、合并骨质疏松症、合并肌少症、肝功能异常、钙磷代谢异常是手术患者发生代谢性骨病相关影响因素,差异均有统计学意义(P<0.05)。经Logistic回归分析显示,年龄(30~60岁,OR=7.985;>60岁,OR=8.566)、体重指数(OR=2.688)、运动习惯(OR=5.096)、透析时间(OR=6.928)、合并基础疾病(OR=4.172)、营养状态(OR=2.766)、25羟维生素D状况(OR=3.823)、合并骨质疏松症(OR=5.511)、合并肌少症(OR=4.364)、肝功能异常(OR=5.825)、钙磷代谢异常(OR=5.825)均为引发代谢性骨病的危险因素(P<0.05)。结论 年龄、运动习惯、透析时间、合并基础疾病、营养状态、25羟维生素D状况、合并骨质疏松症、肌少症、肝功能异常以及钙磷代谢异常均是引发代谢性骨病的危险因素,需做好积极防护举措。

Objective To analyze the incidence and related influencing factors of metabolic bone disease in maintenance hemodialysis patients.Methods A total of 277 patients who underwent maintenance hemodialysis in the Fifth National Sun Yat-sen University Hospital from February 2022 to May 2024 were selected as the research subjects.Descriptive analysis was used to analyze the incidence of metabolic bone disease,and single factor and logistic regression analysis were used to explore the relevant influencing factors.Results The detection rate of metabolic bone disease was 51.62%.Univariate analysis showed that gender,age,body mass index,exercise habits,dialysis time,history of bone pain,nutritional status,25 hydroxyvitamin D status,comorbidities with underlying diseases,comorbidities with osteoporosis,comorbidities with sarcopenia,abnormal liver function,and abnormal calcium and phosphorus metabolism were factors related to the occurrence of metabolic bone disease,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that age(30-60 years old,OR=7.985;>60 years old,OR=8.566),body mass index(OR=2.688),exercise habits(OR=5.096),dialysis time(OR=6.928),comorbidities with underlying diseases(OR=4.172),nutritional status(OR=2.766),25 hydroxyvitamin D status(OR=3.823),comorbidities with osteoporosis(OR=5.511),comorbidities with sarcopenia(OR=4.364),liver dysfunction(OR=5.825),and abnormal calcium and phosphorus metabolism(OR=5.825)were risk factors associated with metabolic bone disease(P<0.05).Conclusion Age,exercise habits,dialysis time,comorbidities,nutritional status,25 hydroxyvitamin D status,comorbidities with osteoporosis,sarcopenia,abnormal liver function,and abnormal calcium and phosphorus metabolism are all risk factors for metabolic bone disease,and active protective measures should be taken.