CAJ | 학술논문

目的：：分析慢性肾脏病( CKD )患者活性维生素 D3水平变化及其相关因素。方法：检测2013年4月~2014年6月本院新诊断的143例非透析CKD患者及19例同期健康体检者维生素D3水平,分析其与肾功能、成纤维细胞生长因子23(血FGF-23)、血钙、血磷、甲状旁腺素(PTH)等指标的关系。结果：CKD1~5期患者维生素 D3水平分别为(22.03±4.39)ng/ml、(20.29±4.66) ng/ml、(16.88±3.00) ng/ml、(13.71±2.99) ng/ml、(9.76±2.97) ng/ml,与对照组(25.68±4.08)ng/ml相比,各组间维生素D3水平逐渐下降(P<0.05)。维生素D3水平与血肌酐(r=-0.676)、尿素氮(r=-0.554)、血磷(r=-0.248)、钙磷乘积(r=-0.178)、PTH(r=-0.636)、FGF-23(r=-0.690)呈负相关(P<0.05),与血钙(r=0.157)、白蛋白(r=0.164)、肾小球滤过率eGFR(r=0.759)呈正相关(P<0.05),多元逐步回归分析显示维生素D3与eGFR呈正相关,与PTH呈负相关。回归方程为Y=13.196+0.092X1-0.016X2( Y为维生素D3,X1为eGFR,X2为PTH,13.196为常数)。结论：随着CKD的进展,患者活性维生素D3缺乏日益严重,且与钙磷代谢紊乱、继发性甲旁亢及FGF-23升高相关。
목적：：분석만성신장병( CKD )환자활성유생소 D3수평변화급기상관인소。방법：검측2013년4월~2014년6월본원신진단적143례비투석CKD환자급19례동기건강체검자유생소D3수평,분석기여신공능、성섬유세포생장인자23(혈FGF-23)、혈개、혈린、갑상방선소(PTH)등지표적관계。결과：CKD1~5기환자유생소 D3수평분별위(22.03±4.39)ng/ml、(20.29±4.66) ng/ml、(16.88±3.00) ng/ml、(13.71±2.99) ng/ml、(9.76±2.97) ng/ml,여대조조(25.68±4.08)ng/ml상비,각조간유생소D3수평축점하강(P<0.05)。유생소D3수평여혈기항(r=-0.676)、뇨소담(r=-0.554)、혈린(r=-0.248)、개린승적(r=-0.178)、PTH(r=-0.636)、FGF-23(r=-0.690)정부상관(P<0.05),여혈개(r=0.157)、백단백(r=0.164)、신소구려과솔eGFR(r=0.759)정정상관(P<0.05),다원축보회귀분석현시유생소D3여eGFR정정상관,여PTH정부상관。회귀방정위Y=13.196+0.092X1-0.016X2( Y위유생소D3,X1위eGFR,X2위PTH,13.196위상수)。결론：수착CKD적진전,환자활성유생소D3결핍일익엄중,차여개린대사문란、계발성갑방항급FGF-23승고상관。
Objective:To explorer the relationship between serum 25(OH)D3(vitamin D3)level and it’s related factors in patients with chronic kidney disease ( CKD ) . Methods:143 non -maintance hemodialysis CKD patients ( newly diagnosed during 2013.4~2014.6) were enrolled, as well as 19 cases of healthy controls(control group), and the levels of vitamin D3, calcium, phosphorus, parathyroid hormone( PTH) , urea nitrogen, creatinine, albumin, and fibroblast growth factors-23 ( FGF-23 ) were detected. Meanwhile, glomerular filtration rate (GFR) was calculated. Results:The level of 25(OH)D3 in stage 1-5 CKD patients were (22. 03 ± 4. 39) ng/ml, (20. 29 ± 4. 66) ng/ml, (16. 88 ± 3. 00) ng/ml, (13. 71 ± 2. 99) ng/ml and (9. 76 ± 2. 97) ng/ml. Compared with control group, serum vitamin D3 level of CKD patients were significantly lower(P<0. 05). Significant negative corre-lations could been observed between serum vitamin D3 leve1 and blood creatinine, BUN, phosphorus, calcium-phosphorus product, PTH and FGF-23 levels and positive correlations between blood vitamin D3 level and blood calcium , albumin and eGFR leve1 were confirmed (P<0. 05). PTH and eGFR entered the regression equation:Y=13. 196+0. 092X1 -0. 016X2, Y meant vitamin D3, X1 eGFR, X2 PTH. Conclusion:With the progression of CKD, vitamin D3 deficient patients is becoming increasingly serious, and was related with the calcium metabolism, phosphorus metabolism, secondary hyperparathyroidism and elevated FGF-23.