摘要
目的分析维持性腹膜透析(PD)患者甲状旁腺激素(PTH)水平的影响因素,并观察其对骨代谢的影响。方法选择2020年1月1日~5月31日于东莞市人民医院肾内科腹膜透析中心进行规律透析治疗及随诊的PD患者167例作为研究对象,根据PTH值将患者分为PTH正常组(≤300 pg/ml)67例和PTH升高组(>300 pg/ml)100例,比较两组一般临床资料及肾功能指标,并采用Spearman相关性分析PTH水平升高组各指标与PTH水平的关系,采用多因素Logistisc回归分析PTH水平升高的影响因素,并分析PTH水平对骨代谢的影响。结果167例PD患者中PTH正常67例,PTH升高100例。两组性别、年龄、原发疾病、HGB、Alb、血脂系列[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、脂蛋白α、同型半胱氨酸(Hcy)]比较,差异无统计学意义(P>0.05);而两组透析龄、淋巴细胞百分率、CO2CP、转氨酶、ALP、PTH、SCr、UREA、CysC水平比较,差异均有统计学意义(P<0.05)。Spearman相关性分析显示,PTH水平与透析龄、UREA、SCr、CO2CP、CysC、淋巴细胞百分率、ALT、尿酸均有相关性(P<0.05)。多因素Logistic回归分析显示,透析龄、CO2CP、ALT、尿酸是PTH水平升高的影响因素。PTH升高组磷和碱性磷酸酶高于PTH正常组,差异有统计学意义(P<0.05);两组钙水平比较,差异无统计学意义(P>0.05)。结论维持性腹膜透析患者PTH过高与透析龄、CO2CP、ALT、尿酸因素有关,对其进行分析研究并进行针对性治疗对改善患者预后及延长存活期具有重要意义。
Objective To analyze the influencing factors of parathyroid hormone(PTH)levels in patients with maintenance peritoneal dialysis(PD),and observe its effects on bone metabolism.Methods 167 PD patients who underwent regular dialysis treatment and follow-up at the Peritoneal Dialysis Center of the Department of Nephrology,Dongguan People’s Hospital from January 1 to May 31,2020 were selected as the research objects.According to the PTH value,patients were divided into PTH normal group(≤300 pg/ml)67 cases and PTH elevated group(>300 pg/ml)100 cases.Compare general clinical data and renal function indicators,and use Spearman correlation to analyze the relationship between each indicator and PTH level in the elevated PTH level group.Multivariate Logistisc regression was used to analyze the influencing factors of the increase of PTH level,and to analyze the influence of PTH level on bone metabolism.Results Among the 167 PD patients,67 had normal PTH and 100 had elevated PTH.Two groups of gender,age,primary disease,HGB,Alb,blood lipid series[total cholesterol(TC),triglycerides(TG),high density lipoprotein(HDL),low density lipoprotein(LDL),lipoproteinα,compared with homocysteine(Hcy)],the difference was not statistically significant(P>0.05);The differences in dialysis age,lymphocyte percentage,CO2CP,transaminase,ALP,PTH,SCr,UREA,CysC levels between the two groups were statistically significant(P<0.05).Spearman correlation analysis showed that PTH levels were correlated with dialysis age,UREA,SCr,CO2CP,CysC,lymphocyte percentage,ALT,and uric acid(P<0.05).Multivariate Logistic regression analysis showed that dialysis age,CO2CP,ALT,and uric acid were the influencing factors for the increase of PTH level.Phosphorus and alkaline phosphatase in the elevated PTH group were higher than those in the normal PTH group,the difference was statistically significant(P<0.05);There was no statistically significant difference in calcium levels between the two groups(P>0.05).Conclusion High PTH in maintenance peritoneal dialysis patients is related to the factors of dialysis age,CO2CP,ALT and uric acid.Analysis and research on it and targeted treatment are of great significance to improve the prognosis of patients and prolong survival.
作者
邓雯懿
徐国玉
刘国辉
DENG Wen-yi;XU Guo-yu;LIU Guo-hui(The First Clinical Medical College of Guangdong Medical University,Zhanjiang 524023,Guangdong,China;Department of Nephrology,Dongguan People's Hospital,Southern Medical University,Dongguan 523808,Guangdong,China)
出处
《医学信息》
2021年第12期106-110,共5页
Journal of Medical Information
关键词
维持性腹膜透析
甲状旁腺激素
骨代谢
Maintenance peritoneal dialysis
Parathyroid hormone
Bone metabolism
作者简介
邓雯懿(1994.1-),女,广东东莞人,硕士研究生,主要从事腹膜透析的研究;通讯作者:刘国辉(1968.9-),男,广东东莞人,本科,主任医师,研究生导师,主要从事中西医结合治疗肾病综合征、肾小球肾炎、血液透析、腹膜透析的诊疗工作。
