蚌埠市维持血液透析患者钙磷代谢及全段甲状旁腺激素控制情况横断面调查

A cross-sectional survey on the control of the metabolism of calcium and phosphorus and the level of parathyroid hormone in maintained hemodialysis patients in Bengbu City

目的了解蚌埠市维持性血液透析患者钙磷代谢及全段甲状旁腺激素(intact parathyroid hormone,i PTH)控制情况。方法问卷调查蚌埠市蚌埠医学院第一、第二附属医院血液透析治疗>3个月的患者,记录患者一般人口学资料、合并症,测定血清钙磷及i PTH水平,分析维持性血液透析患者校正血钙、血磷、钙磷乘积和i PTH达标率,并分析血清i PTH水平与血红蛋白(hemoglobin,Hb)、血钙、血磷、钙磷乘积等临床资料相关性。结果本研究纳入170例维持性血液透析患者,以2003年KDOQI CKD-MBD指南为依据,校正血钙、血磷、钙磷乘积和i PTH的达标率分别为44.7%、44.1%、71.3%和27.6%。血清i PTH水平与年龄、Hb及血钙水平呈负相关,与血肌酐水平呈正相关。结论蚌埠市维持性血液透析患者血清钙磷及i PTH控制不理想;低血钙、低血红蛋白水平可能是i PTH升高的危险因素。

Objective To investigate the control effect of serum calcium,phosphorus and intact parathyroid hormone( i PTH) in the maintained hemodialysis patients in Bengbu. Methods Maintained hemodialysis patients who had dialyzed for more than 3 months from the first and the second affiliated hospital of Bengbu Medical College were enrolled in this cross-sectional study. The demographic data,complications were collected and serum calcium,phosphorus and i PTH were analyzed. The achievement of serum calcium,phosphorus and i PTH were calculated according to 2003 K / DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease or 2009 KDIGO clinical practice guideline for the diagnosis,evaluation,prevention,and treatment of Chronic Kidney Disease-Mineral and Bone Disorder( CKDMBD). The relationship between i PTH and clinical data such as Hb,serum calcium,serum phosphorus,and multiplications were also analyzed. Results A total of 170 maintained hemodialysis patients were included in the study. In accordance with standards in K / DOQI CKD-MBD,2003,44. 7% samples of serum calcium concentration,44. 1% serum phosphate,71. 3% calcium-phosphorus product and 27. 6% i PTH met the standards. The i PTH levels were negatively correlaed with age,Hb,serum calcium levels and positive correlated with serum creatinine levels. Conclusions The controlling of serum calcium,phosphorus and i PTH levels in the maintained hemodialysis patients seems not to be ideal in Bengbu city.These results suggested that low serum calcium levels and low hemoglobin levels may be involved in high i PTH.