血清PTH、ALP指标与维持性血液透析患者钙磷代谢紊乱的关系

The Relationship between Serum PTH,ALP Indicators and Calcium and Phosphorus Metabolism Disorders in Maintenance Hemodialysis Patients

目的:探讨维持性血液透析(MHD)患者钙磷代谢紊乱的发生情况,并分析其发生与血清甲状旁腺激素(PTH)、碱性磷酸酶(ALP)的关系。方法:选择上饶市中医院2022年7月—2023年9月收治的80例MHD患者,统计患者入院时一般资料,检测血清PTH、ALP水平,并依据MHD 3个月时钙磷代谢紊乱发生情况分为钙磷代谢紊乱组和钙磷代谢正常组,分析血清PTH、ALP水平与MHD患者钙磷代谢紊乱的关系。结果:80例MHD患者透析3个月时出现钙磷代谢紊乱33例,发生率为41.25%;两组年龄、性别、原发疾病、病程、体重指数、收缩压、舒张压、吸烟史、饮酒史及血磷、血钙、尿酸、血红蛋白、总胆固醇、甘油三酯、空腹血糖水平比较,差异均无统计学意义(P>0.05);钙磷代谢紊乱组肌酐、血清PTH、ALP、超敏C反应蛋白水平均高于钙磷代谢正常组,差异均有统计学意义(P<0.05);经logistic回归分析结果显示,肌酐、PTH、ALP、超敏C反应蛋白是MHD患者钙磷代谢紊乱发生的危险因素(OR>1,P<0.05);绘制受试者操作特征(ROC)曲线,结果显示,血清PTH、ALP水平单独及联合预测MHD患者钙磷代谢紊乱的AUC分别为0.853、0.837、0.925,具有一定预测价值。结论:血清PTH、ALP水平与MHD患者发生钙磷代谢紊乱密切相关,且对预测钙磷代谢紊乱的发生具有一定预测价值。

Objective:To explore the occurrence of calcium and phosphorus metabolism disorders in maintenance hemodialysis(MHD)patients,and analyze the relationship between the disorder and serum parathyroid hormone(PTH),alkaline phosphatase(ALP).Method:A total of 80 MHD patients admitted to Shangrao Traditional Chinese Medicine Hospital from July 2022 to September 2023 were selected.The general data of patients at admission were collected,serum PTH and ALP levels were detected,and the patients were divided into calcium and phosphorus metabolism disorder group and normal calcium and phosphorus metabolism group according to the occurrence of calcium and phosphorus metabolism disorder at 3 months of MHD.The relationship between serum PTH,ALP levels and calcium and phosphorus metabolism disorder in MHD patients was analyzed.Result:Among 80 MHD patients,33 cases had calcium and phosphorus metabolism disorder after 3 months of dialysis,with an incidence rate of 41.25%.There were no statistical significant differences in age,gender,primary disease,course of disease,body mass index,systolic blood pressure,diastolic blood pressure,smoking history,drinking history,and blood phosphorus,calcium,uric acid,hemoglobin,total cholesterol,triglycerides,and fasting blood glucose levels between two groups(P>0.05).The levels of creatinine,serum PTH,ALP,and hypersensitive C reactive protein in calcium and phosphorus metabolism disorder group were higher than those in normal calcium and phosphorus metabolism group,the differences were statistically significant(P<0.05).The results of logistic regression analysis showed that creatinine,PTH,ALP,and hypersensitive C reactive protein were risk factors for calcium and phosphorus metabolism disorders in MHD patients(OR>1,P<0.05).Receiver operating characteristic(ROC)curve was drawn,and the results showed that serum PTH and ALP levels alone and in combination predict the AUC of calcium and phosphorus metabolism disorders in MHD patients,which were 0.853,0.837,and 0.925,respectively,and had certain predictive value.Conclusion:The levels of serum PTH and ALP are closely related to the occurrence of calcium and phosphorus metabolism disorders in MHD patients,and have certain predictive value in predicting the occurrence of calcium and phosphorus metabolism disorders.