摘要
目的分析维持性血液透析(MHD)患者的钙、磷、全段甲状旁腺素(PTH)代谢情况及其与心血管病变发生的关系。方法从2020年8月-2021年7月就诊的MHD患者中选取86例纳为研究对象。分析患者的临床资料,统计其血钙、血磷及PTH的达标率;根据是否发生心血管事件将86例患者分为心血管事件组(n=45)和非心血管事件组(n=41),比较两组患者的血钙、血磷及PTH水平,分析MHD患者的钙磷代谢紊乱对其心血管病变发生的影响。结果86例患者中平均血钙达标率61.63%,平均血磷达标率41.86%,平均PTH达标率22.09%;其中低钙血症为15.12%,高钙血症为23.26%,高磷血症为34.88%,低PTH为23.26%,高PTH为54.65%,该组患者的血钙及PTH达标情况与DOPPS4结果比较差异有统计学意义(P均<0.05),血磷达标情况与DOPPS4结果比较差异无统计学意义(P>0.05);心血管事件组的血钙水平显著低于非心血管事件组,血磷及PTH水平显著高于非心血管事件组(P均<0.05),比较两组患者的临床资料,显示血磷、高血压、钙磷乘积及PTH水平是影响MHD患者产生心血管事件的单因素(P均<0.05),进一步logistics回归分析显示,血磷(>1.78 mmol/L)、PTH(>300ng/L)、钙磷乘积(>40.00mg^(2)/dL^(2))、高血压(≥180mmHg)为引发MHD患者心血管病变的独立危险因素(P均<0.05)。结论MHD患者的心血管事件发生情况与高血压及钙磷代谢水平相关,且血磷(>1.78mmol/L)、PTH(>300ng/L)、钙磷乘积(>40.00mg^(2)/dL^(2))、高血压(≥180mmHg)是引发心血管事件的独立危险因素,日常治疗中应注重对患者钙磷代谢紊乱的监测及纠正。
Objective To analyze the metabolism status of calcium,phosphorus and intact parathyroid hormone(PTH)in patients with maintenance hemodialysis(MHD)and their relationship with the occurrence of cardiovascular diseases.Methods 86 patients with MHD who came to the hospital for treatment from August 2020 to July 2021 were selected as the research subjects.The clinical data of patients were analyzed,and the compliance rates of blood calcium,blood phosphorus and PTH were statistically analyzed.86 patients were divided into cardiovascular event group(n=45)and non-cardiovascular event group(n=41)according to whether the cardiovascular events occurred.The levels of blood calcium,blood phosphorus and PTH were compared between the two groups,and the influence of calcium-phosphorus metabolism disorder on the occurrence of cardiovascular diseases was analyzed in patients with MHD.Results Among the 86 patients,the compliance rates of average blood calcium,average blood phosphorus and average PTH were 61.63%,41.86%and 22.09%.The incidence rates of hypocalcemia,hypercalcemia,hyperphosphatemia,low PTH and high PTH were 15.12%,23.26%,34.88%,23.26%and 54.65%,and there were statistically significant differences in the compliance status of blood calcium and PTH compared to the results of DOPPS4(all P<0.05),but there was no significant difference in the compliance status of blood phosphorus compared to DOPPS4 result(P>0.05).The blood calcium level of cardiovascular event group was significantly lower than that of non-cardiovascular event group while the levels of blood phosphorus and PTH were significantly higher than those of non-cardiovascular event group(all P<0.05).Clinical data of the two groups of patients showed that hypertension,blood phosphorus,calcium-phosphorus product and PTH were single factors affecting the cardiovascular events in patients with MHD(all P<0.05).Further logistics regression analysis showed that blood phosphorus(>1.78 mmol/L),PTH(>300 ng/L),calcium-phosphorus product(>40.00 mg^(2)/dL^(2))and hypertension(≥180 mmHg)were independent risk factors for cardiovascular diseases in patients with MHD(all P<0.05).Conclusion The occurrence of cardiovascular events in patients with MHD is related to hypertension and calcium-phosphorus metabolism,and blood phosphorus(>1.78 mmol/L),PTH(>300 ng/L),calcium-phosphorus product(>40.00 mg^(2)/dL^(2))and hypertension(≥180 mmHg)are independent risk factors for cardiovascular events.In daily treatment,it is necessary to pay attention to the monitoring and correction of the calcium-phosphorus metabolism disorder.
作者
张莹
贾慧霞
ZHANG Ying;JIA Hui-xia(Blood Purification Center,Xuchang Central Hospital,Xuchang,Henan,461000,China)
出处
《中国血液流变学杂志》
CAS
2023年第1期136-140,F0003,共6页
Chinese Journal of Hemorheology
关键词
维持性血液透析
钙磷代谢
心血管事件
危险因素
相关性
maintenance hemodialysis
calcium-phosphorus metabolism
cardiovascular events
risk factors
correlation
作者简介
张莹(1984-),女,河南省许昌人,学士,研究方向:血液净化。
