摘要
目的分析终末期肾脏病患者的钙磷代谢及甲状旁腺激素水平临床关系,为临床治疗终末期肾脏病患者提供科学依据。方法选取2010年1月-2014年12月86例在医院进行诊治的终末期肾脏病患者的临床资料进行回顾性分析,观察患者的血清免疫活性甲状旁腺素(iPTH)、血清肌酐(Scr)、血清白蛋白(Alb)、二氧化碳结合力(CO2CP)、血清钙及血磷水平,使用全自动血液检测仪进行分析数据采用SPSS16.0统计软件进行分析。结果 86例终末期肾脏病患者中有70例患者存在高磷血症占81.4%;13例患者血清钙水平较低占15.11%,20例患者血清钙水平偏高占23.26%;且有23例占26.74%患者服用含钙磷结合剂或活性维生素D,比较低血钙和血钙正常患者的相关指标发现,低血钙患者的CO2CP低于血钙正常组患者,差异有统计学意义(P<0.05);15例患者iPTH<100ng/L占17.44%,多数是慢性肾小管疾病患者;40例患者iPTH>300ng/L占46.51%,大部分是慢性肾小球肾炎患者,回顾性分析发现,矫正后血钙水平与患者的iPTH呈负相关。结论终末期肾脏病感染患者中高血磷症发生率高,且有50.00%患者出现继发性甲状旁腺激素水平增高,患者的矫正后血钙水平除了与服用含钙磷结合剂或活性维生素D外,可能与酸中毒有一定关联。
OBJECTIVE To analyze the clinical relationship of calcium and phosphorus metabolism and parathyroid hormone levels in end-stage renal disease and provide scientific basis for the clinical treatment of end-stage renal disease.METHODS Clinical data of 86 patients with end-stage renal disease during Jan.2010-Dec.2014 were retrospectively analyzed.Levels of intact parathyroid hormone（iPTH）,serum creatinine（Scr）,serum albumin（Alb）,carbon dioxide combining power（CO2CP）,serum calcium and serum phosphate were observed by full-auto blood flow detector.Data were analyzed by software SPSS16.0.RESULTS Among the 86 patients with end-stage renal disease,70（81.4%）patients had hyperphosphatemia,13（15.11%）had lower serum calcium levels,20（23.26%）had higher serum calcium levels and 23（26.74%）used calcium-containing phosphate binders or active vitamin D.The comparison of related indexes between patients with low serum calcium and those with normal serum calcium found that CO2 CP was significantly lower in the former than in the normal patients（P〈0.05）.There were 15（17.44%）patients with iPTH100ng/L,most of whom had chronic renal tubular diseases.There were40（46.51%）patients with iPTH300ng/L,most of whom had chronic glomerulonephritis.The respective analysis found the corrected serum calcium level was negatively correlated with iPTH.CONCLUSIONPatients with end-stage renal disease had high incidence of hyperglycemia,and 50.00% of the patients had secondary increased hyperparathyroidism hormone levels.The serum calcium levels in patients after correction were associated with calcium-containing phosphate binders or active vitamin D,and it may have some association with acidosis.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第4期821-823,共3页
Chinese Journal of Nosocomiology
基金
广东省医学科研基金资助项目(A2011078)
关键词
终末期肾脏病
感染
钙磷代谢
甲状旁腺激素
End-stage renal disease
Infection
Calcium and phosphorus metabolism
Parathyroid hormone
