CAJ | 학술논문

目的通过调查慢性肾脏病(CKD)1～3期患者25(OH)D水平,探讨25(OH)D的影响因素,为CKD患者早期进行维生素D缺乏的预防及治疗提供依据.方法采用放射免疫法检测89例CKD 1 ～3期患者25(OH)D水平,采用自动生化仪测定血钙、磷、碱性磷酸酶、总蛋白、白蛋白、肌酐,24 h尿蛋白定量及微量清蛋白、尿钙等.采用单因素相关分析探讨25 (OH)D的影响因素.25(OH)D的独立影响因素采用多元线性回归分析.结果 89例CKD患者25(OH)D水平中位数11.0 μg/L,全距3.0 ～ 39.0 μg/L,维生素D不足者占28.1％(25/89),缺乏者占68.5％(61/89).CKD1～3期各期间25(OH)D比较差异无统计学意义(P＞0.05).单因素相关分析提示:25(OH)D与激素使用、校正钙、促甲状腺激素、24 h尿蛋白定量、24 h尿微量白蛋白呈负相关,与总蛋白及白蛋白呈正相关.多元线性回归分析提示:校正钙、白蛋白是25(OH)D水平的独立影响因素.结论 CKD 1 ～3期患者普遍存在维生素D缺乏,校正钙、白蛋白是25(OH)D水平的独立影响因素.
목적 통과조사만성신장병(CKD)1～3기환자25(OH)D수평,탐토25(OH)D적영향인소,위CKD환자조기진행유생소D결핍적예방급치료제공의거.방법 채용방사면역법검측89례CKD 1 ～3기환자25(OH)D수평,채용자동생화의측정혈개、린、감성린산매、총단백、백단백、기항,24 h뇨단백정량급미량청단백、뇨개등.채용단인소상관분석탐토25 (OH)D적영향인소.25(OH)D적독립영향인소채용다원선성회귀분석.결과 89례CKD환자25(OH)D수평중위수11.0 μg/L,전거3.0 ～ 39.0 μg/L,유생소D불족자점28.1％(25/89),결핍자점68.5％(61/89).CKD1～3기각기간25(OH)D비교차이무통계학의의(P＞0.05).단인소상관분석제시:25(OH)D여격소사용、교정개、촉갑상선격소、24 h뇨단백정량、24 h뇨미량백단백정부상관,여총단백급백단백정정상관.다원선성회귀분석제시:교정개、백단백시25(OH)D수평적독립영향인소.결론 CKD 1 ～3기환자보편존재유생소D결핍,교정개、백단백시25(OH)D수평적독립영향인소.
Objective To observe the level of vitamin D [25 (OH)D] in patients with chronic kidney disease (CKD) at stage 1-3,and explore the influencing factors.Methods Eighty-nine patients with CKD at stage 1-3 were selected.The 25 (OH)D was detected by radioimmunoassay.Using automatic biochemical analyzer,serum calcium,phosphate,alkaline phosphatase,total protein,albumin,creatinine,24 h urine protein quantitation and micro-albumin and urinary calcium,etc were detected.The influencing factors of 25 (OH)D were analyzed by single factor correlation analysis.The independent influencing factors of 25 (OH)D were analyzed by multiple linear regression analyses.Results The median of 25 (OH)D level in 89 patients with CKD at stage 1-3 was 11.0 μg/L,and full range was 3.0-39.0 μg/L.The rate of vitamin D insufficiency was 28.1％ (25/89),and the rate of deficiency was 68.5％ (61/89).There were no significant differences in 25 (OH)D among different CKD stages (P ＞ 0.05).Single factor correlation analysis result showed that 25 (OH)D was negatively correlated with glucocorticoid,corrected calcium,thyroid stimulating hormone,24 h urine protein quantitation,24 h urine micro-albumin,and 25 (OH)D was positively correlated with total protein and albumin.Multiple linear regression analyses result showed that the corrected calcium and albumin were the independent influencing factors of 25 (OH)D.Conclusions Vitamin D insufficiency or deficiency is common in different stage of CKD 1-3 patients.Multiple linear regression analyses shows that albumin and correction calcium are the independent influencing factors of 25(OH)D level.