CAJ | 학술논문

目的：探讨维持性血液透析（MHD）患者25-羟维生素D[25（OH）D]水平及其影响因素。方法：选择MHD患者116例，检测血清25（ OH） D水平并分为三组：维生素D缺乏组（ n＝31）、不足组（n＝61）、正常组（n＝24）。检测各项血生化指标，包括白蛋白（Alb）、促红细胞生成素浓度（EPO）、血钙（Ca）、血磷（P）、甘油三酯（TG）、低密度脂蛋白（LDL）、全段甲状旁腺素（iPTH）、高敏C反应蛋白（ hs-CRP ）、氨基末端脑钠肽前体（ NT-proBNP ）等，并统计分析。结果：维生素D缺乏组和不足组中男性比例显著高于正常组。维生素D缺乏组TG、LDL显著高于正常组（ P 均＜0．05）。缺乏组hsCRP 和NT-proBNP 显著高于不足组和对照组（ P均＜0．05），其余各项指标无显著差异。逐步回归分析发现hsCRP（β＝-0．496，F＝8．128，P＜0．001）、LDL（β＝-0．315，F＝4．42l，P＝0．015）、TG （β＝-0．065， F＝3．542，P＝0．032）是影响25（ OH） D水平的重要因素。结论：MHD患者中存在明显的维生素D缺乏或不足，hsCRP、LDL、TG是血25（ OH） D的独立影响因素，建议对严重缺乏维生素D的MHD患者酌情补充维生素D。
목적：탐토유지성혈액투석（MHD）환자25-간유생소D[25（OH）D]수평급기영향인소。방법：선택MHD환자116례，검측혈청25（ OH） D수평병분위삼조：유생소D결핍조（ n＝31）、불족조（n＝61）、정상조（n＝24）。검측각항혈생화지표，포괄백단백（Alb）、촉홍세포생성소농도（EPO）、혈개（Ca）、혈린（P）、감유삼지（TG）、저밀도지단백（LDL）、전단갑상방선소（iPTH）、고민C반응단백（ hs-CRP ）、안기말단뇌납태전체（ NT-proBNP ）등，병통계분석。결과：유생소D결핍조화불족조중남성비례현저고우정상조。유생소D결핍조TG、LDL현저고우정상조（ P 균＜0．05）。결핍조hsCRP 화NT-proBNP 현저고우불족조화대조조（ P균＜0．05），기여각항지표무현저차이。축보회귀분석발현hsCRP（β＝-0．496，F＝8．128，P＜0．001）、LDL（β＝-0．315，F＝4．42l，P＝0．015）、TG （β＝-0．065， F＝3．542，P＝0．032）시영향25（ OH） D수평적중요인소。결론：MHD환자중존재명현적유생소D결핍혹불족，hsCRP、LDL、TG시혈25（ OH） D적독립영향인소，건의대엄중결핍유생소D적MHD환자작정보충유생소D。
Objective:To investigate the 25-hydroxyvitamin D [25 (OH) D] levels and their influen-cing factors in patients with maintenance hemodialysis ( MHD) .Method:A total of 116 cases of MHD pa-tients were collected and divided into three groups in accordance with serum 25 ( OH) D levels:Deficiency group ( n =31) , insufficient group ( n =61) and normal group ( n =24) .Serum levels of biochemistry in-cluding albumin (Alb), erythropoietin concentration (EPO), calcium (Ca), phosphorus (P), triglycer-ides (TG), low density lipoprotein (LDL), intact parathyroid hormone (iPTH), high-sensitivity C-reac-tive protein ( hs-CRP ) , amino-terminal pro-brain natriuretic peptide ( NT-proBNP ) .were detected and statistical analyzed .Result: Male ratio was significantly higher in deficiency group and insufficient group than the normal group .TG, LDL in vitamin D deficiency group were significantly higher than normal group ( P <0.05) .hsCRP and NT-proBNP were significantly higher in deficiency group than insufficient group and normal group (P <0.05).The rest of the indicators had no significant differences .Stepwise regression analy-sis showed that hsCRP (β=-0.496, F =8.128, P <0.001) , LDL (β=-0.315, F =4.42l, P =0. 015), TG (β=-0.065, F =3.542 , P =0.032) were affecting 25 (OH) D levels and they were the in-dependent factors .Conclusion:Serum hsCRP , LDL, TG levels were independent factors of 25 ( OH) D, MHD patients with deficient or insufficient vitamin D , which suggested an appropriate supplemental vitamin D for MHD patients with a serious lack of vitamin D .