| 韩建芳,李丽华,王宁宁,陶宜莹,苟晶琦.维持性血液透析患者慢性肾脏病矿物质和骨异常患病情况调查及血管钙化的危险因素分析[J].,2020,(5):953-956 |
| 维持性血液透析患者慢性肾脏病矿物质和骨异常患病情况调查及血管钙化的危险因素分析 |
| Investigation of Chronic Kidney Disease-Mineral Bone Disorder in Maintenance Hemodialysis Patients and Analysis of Risk Factors for Vascular Calcification |
| 投稿时间：2019-06-28 修订日期：2019-07-23 |
| DOI：10.13241/j.cnki.pmb.2020.05.034 |
| 中文关键词: 维持性血液透析 慢性肾脏病 矿物质和骨异常 血管钙化 影响因素 |
| 英文关键词: Maintenance hemodialysis Chronic renal disease Mineral and bone abnormalities Vascular calcification Influence factor |
| 基金项目:青海省科技计划项目（2015-ZJ-748） |
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| 中文摘要: |
| 摘要 目的：调查维持性血液透析（MHD）患者慢性肾脏病矿物质和骨异常（CKD-MBD）患病情况，并分析血管钙化的危险因素。方法：选取2017年2月～2018年12月我院收治的MHD患者229例记为研究对象。统计并记录所有患者CKD-MBD患病情况，并通过Kauppila评分对所有患者的血管钙化情况予以评定，将患者按照Kauppila评分结果分为钙化组与非钙化组。比较两组患者基本资料以及血生化指标水平，并采用多因素Logistic回归分析MHD患者血管钙化的影响因素。结果：229例MHD患者中CKD-MBD患病率按照从高到低的顺序分别为高甲状旁腺激素（PTH）、高磷血症、低钙血症、低PTH、高钙血症、低磷血症，占比分别为45.85%、42.36%、30.57%、20.09%、19.65%、10.04%。229例MHD患者血管钙化发生率为68.56%。钙化组年龄、透析时间、血磷、颈动脉内膜中层厚度（IMT）、超敏C反应蛋白（hs-CRP）水平均高于非钙化组（均P＜0.05）。经多因素Logistic回归分析可得：年龄、透析时间、hs-CRP均是MHD患者血管钙化的独立危险因素（均P＜0.05）。结论：MHD患者CKD-MBD患病情况不容乐观，多见于高PTH、高磷血症、低钙血症。其中年龄、透析时间、hs-CRP均与MHD患者血管钙化密切相关，值得临床重点关注。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the prevalence of Chronic Kidney Disease-Mineral Bone Disorder (CKD-MBD) in patients undergoing maintenance hemodialysis (MHD), and to analyze the risk factors for vascular calcification. Methods: 229 MHD patients who were admitted to our hospital from February 2017 to December 2018 were selected as the study subjects. All patients with CKD-MBD were counted and recorded, and all patients were assessed for vascular calcification by Kauppila score. The patients were divided into calcification group and non-calcification group according to the Kauppila score. The basic data and blood biochemical indexes of the two groups were compared, and multivariate Logistic regression was used to analyze the influencing factors of vascular calcification in MHD patients. Results: The prevalence of CKD-MBD in 229 MHD patients was from high to low in the order of high parathyroid hormone (PTH), high phosphatemia, low calcemia, low PTH, high calcemia and low phosphatemia, accounting for 45.85%, 42.36%, 30.57%, 20.09%, 19.65% and 10.04%, respectively. The incidence of vascular calcification in 229 MHD patients was 68.56%. The age, dialysis time, blood phosphorus, intima-media thickness (IMT) and hypersensitive C-reactive protein (hs-CRP) levels in the calcification group were all higher than those in the non-calcification group (all P<0.05). Multivariate Logistic regression analysis showed that age, duration of dialysis, and hs-CRP were independent risk factors for vascular calcification in MHD patients (all P<0.05). Conclusion: The prevalence of CKD-MBD in MHD patients is not optimistic. which is mainly found in high PTH, high phosphatemia, low calcemia. Among them, age, duration of dialysis and hs-CRP are closely related to vascular calcification in MHD patients, which is worthy of clinical attention. |
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