国际移植与血液净化杂志
國際移植與血液淨化雜誌
국제이식여혈액정화잡지
INTERNATIONAL JOURNAL OF TRANSPLANTATION AND HEMOPURIFICATION
2014年
3期
13-16
,共4页
肾透析%矿物质%代谢%甲状旁腺机能亢进症,继发性
腎透析%礦物質%代謝%甲狀徬腺機能亢進癥,繼髮性
신투석%광물질%대사%갑상방선궤능항진증,계발성
Renal dialysis%Minerals%Metablism%Hyperparathyroidism,secondary
目的 探讨新乡地区维持性血液透析(MHD)患者矿物质代谢现况及相关影响因素,以提高本地区MHD患者生存质量.方法 收集2012年1月至2013年8月新乡地区4家综合性医院466例MHD3个月以上患者的临床资料.检测血清钙离子、磷、全段甲状旁腺激素(iPTH)及碱性磷酸酶(ALP)水平.分析MHD患者矿物质代谢现况及其与年龄、透析龄、营养不良、透析充分性的关系.结果 466例患者血钙平均值为(1.95±0.34) mmol/L,血磷平均值为(2.54± 1.38)mmol/L,iPTH平均值为(409±346)ng/L;钙、磷、iPTH达标率分别为34.3％(160/466)、20.4％(95/466)和25.5％ (119/466).年龄≥60岁组(n=159)患者的血磷[(2.27±0.95)mmol/L比(2.68± 1.54) mmol/L]、iPTH[(344±235) ng/L比(437±383)ng/L]、ALP值[(49.0±36.4)mmol/L比(77.1±78.5) mmol/L]均低于年龄＜60岁组(n=307)(P均＜0.01).iPTH＞ 300ng/L组(n=242)的血磷、ALP、透析龄明显高于iPTH≤300 ng/L组(n=224)(均P＜0.01).透析龄≥24个月组(n=228)患者的血磷[(2.70±1.49) mmol/L比(2.35±1.20) mmol/L]、血钙[(1.88±0.35) mmol/L比(2.03±0.31) mmol/L]、iPTH[(493±384) ng/L比(301±249) ng/L]、ALP值[(74.3±73.3) mmol/L比(52.0±51.0)mmol/L]与透析龄＜24个月组(n=238)比较差异均有统计学意义(均P＜0.05).结论 该地区MHD患者存在着明显的矿物质代谢紊乱及甲状旁腺机能亢进症,透析龄长的患者及年轻透析患者高磷血症、低钙血症更为突出.
目的 探討新鄉地區維持性血液透析(MHD)患者礦物質代謝現況及相關影響因素,以提高本地區MHD患者生存質量.方法 收集2012年1月至2013年8月新鄉地區4傢綜閤性醫院466例MHD3箇月以上患者的臨床資料.檢測血清鈣離子、燐、全段甲狀徬腺激素(iPTH)及堿性燐痠酶(ALP)水平.分析MHD患者礦物質代謝現況及其與年齡、透析齡、營養不良、透析充分性的關繫.結果 466例患者血鈣平均值為(1.95±0.34) mmol/L,血燐平均值為(2.54± 1.38)mmol/L,iPTH平均值為(409±346)ng/L;鈣、燐、iPTH達標率分彆為34.3％(160/466)、20.4％(95/466)和25.5％ (119/466).年齡≥60歲組(n=159)患者的血燐[(2.27±0.95)mmol/L比(2.68± 1.54) mmol/L]、iPTH[(344±235) ng/L比(437±383)ng/L]、ALP值[(49.0±36.4)mmol/L比(77.1±78.5) mmol/L]均低于年齡＜60歲組(n=307)(P均＜0.01).iPTH＞ 300ng/L組(n=242)的血燐、ALP、透析齡明顯高于iPTH≤300 ng/L組(n=224)(均P＜0.01).透析齡≥24箇月組(n=228)患者的血燐[(2.70±1.49) mmol/L比(2.35±1.20) mmol/L]、血鈣[(1.88±0.35) mmol/L比(2.03±0.31) mmol/L]、iPTH[(493±384) ng/L比(301±249) ng/L]、ALP值[(74.3±73.3) mmol/L比(52.0±51.0)mmol/L]與透析齡＜24箇月組(n=238)比較差異均有統計學意義(均P＜0.05).結論 該地區MHD患者存在著明顯的礦物質代謝紊亂及甲狀徬腺機能亢進癥,透析齡長的患者及年輕透析患者高燐血癥、低鈣血癥更為突齣.
목적 탐토신향지구유지성혈액투석(MHD)환자광물질대사현황급상관영향인소,이제고본지구MHD환자생존질량.방법 수집2012년1월지2013년8월신향지구4가종합성의원466례MHD3개월이상환자적림상자료.검측혈청개리자、린、전단갑상방선격소(iPTH)급감성린산매(ALP)수평.분석MHD환자광물질대사현황급기여년령、투석령、영양불량、투석충분성적관계.결과 466례환자혈개평균치위(1.95±0.34) mmol/L,혈린평균치위(2.54± 1.38)mmol/L,iPTH평균치위(409±346)ng/L;개、린、iPTH체표솔분별위34.3％(160/466)、20.4％(95/466)화25.5％ (119/466).년령≥60세조(n=159)환자적혈린[(2.27±0.95)mmol/L비(2.68± 1.54) mmol/L]、iPTH[(344±235) ng/L비(437±383)ng/L]、ALP치[(49.0±36.4)mmol/L비(77.1±78.5) mmol/L]균저우년령＜60세조(n=307)(P균＜0.01).iPTH＞ 300ng/L조(n=242)적혈린、ALP、투석령명현고우iPTH≤300 ng/L조(n=224)(균P＜0.01).투석령≥24개월조(n=228)환자적혈린[(2.70±1.49) mmol/L비(2.35±1.20) mmol/L]、혈개[(1.88±0.35) mmol/L비(2.03±0.31) mmol/L]、iPTH[(493±384) ng/L비(301±249) ng/L]、ALP치[(74.3±73.3) mmol/L비(52.0±51.0)mmol/L]여투석령＜24개월조(n=238)비교차이균유통계학의의(균P＜0.05).결론 해지구MHD환자존재착명현적광물질대사문란급갑상방선궤능항진증,투석령장적환자급년경투석환자고린혈증、저개혈증경위돌출.
Objective To investigate the present situation and related factors of the mineral metabolism in patients,with maintenance hemodialysis (MHD).Methods A total of 466 MHD patients clinical data in 4 hospital in Xinxiang didtrict during January 2012 and August 2013 were enrolled in this study,and they received a minimum of 3 months' MHD therapy.The evaluation index of all 466 MHD patients were monitored,such as serum calcium,serum phosphorus,intact parathyroid hormone(iPTH) and alkaline phosphatase(ALP).Results The level of serum calcium,serum phosphorus and iPTH in 466 MHD patients was (1.95 ± 0.34) mmol/L,(2.54 ± 1.38) mmol/L and (409 ± 346) ng/L,and the control rate of them was 34.3％ (160/466),20.4％ (95/466) and 25.5％ (119/466),respectively.The level of serum phosphorus[(2.27 ± 0.95) mmol/L vs(2.68 ± 1.54) mmol/L],iPTH [(344 ± 235)ng/L vs (437 ± 383)ng/L],ALP[(49.0± 36.4) mmol/L vs(77.1 ± 78.5)mmol/L] in the group of age≥ 60 years old (n =159) was obviously lower than that in the group of age ＜ 60 years old(n =307) (all P ＜ 0.01).And the level of serum phosphorus,alkaline phosphatase and dialysis ages in the group of iPTH ＞ 300 ng/L was higher than that in the group of iPTH ≤ 300 ng/L(P ＜ 0.01).There was statistical significance with the level of serum calcium,serum phosphorus,ALP and iPTH between the dialysis ages≥ 24 months and dialysis ages ＜ 24 months(all P ＜ 0.05).Conclusions There were obvious disorder of mineral metabolism and hyperparathyroidism with the MHD patients in Xinxiang District.With the delay of the dialysis,the hyperphosphatemia and hypocalcemia is more outstanding in these patients.
