中国血液净化

中国血液净化 ›› 2021, Vol. 20 ›› Issue (03): 176-180.doi: 10.3969/j.issn.1671-4091.2021.03.007

• 临床研究 • 上一篇    下一篇

维持性血液透析患者全血微量元素与甲状旁腺激素水平的相关性分析

郭浩楠1,刘云1,谭荣韶2,刘岩1,钟小仕1   

  1. 暨南大学附属广州红十字会医院1肾内科，2临床病态营养研究所
  • 收稿日期:2020-08-24 修回日期:2020-12-27 出版日期:2021-03-12 发布日期:2021-03-12
  • 通讯作者: 钟小仕 2453075701@qq.com E-mail:zxshhyy@medmail.com.cn
  • 基金资助:
    2016 年广东省科技厅项目基金(2016A020215023)；广东省科技计划项目基金(2014B030303002)；
    广东省科技计划项目基金(2017B090904027)；广州市卫生与计划生育科技项目(20181A011020)

Correlation analysis between whole blood trace elements and parathyroid hormone level in maintenance hemodialysis patients 

  1. 1Department of Nephrology, 2Institute of Disease-Oriented Nutritional Research, Guangzhou Red Cross Hospital, Jinan University, Guangzhou 510220, China
  • Received:2020-08-24 Revised:2020-12-27 Online:2021-03-12 Published:2021-03-12

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摘要： 【摘要】目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者血清甲状旁腺激素(parathyroid hormone,PTH)与全血微量元素之间的关系。方法采用单中心横断面研究，纳入2019 年9 月在暨南大学附属广州红十字会医院血液透析中心行MHD 的患者。记录患者临床资料、用药情况，测定透析前血常规、血清生化指标和全血微量元素锌、铜、锰、铅、硒(电感耦合等离子体质谱仪法)。根据血清PTH 数值分为高PTH 组(PTH≥300pg/ml)和低PTH 组(PTH＜300pg/ml)，比较2 组患者的临床特征。应用单因素和多因素logistic 回归分析PTH≥300pg/ml 的相关因素。结果共纳入MHD 患者153 例，其中高PTH 组46 例，低PTH 组107 例。与低PTH 组患者相比，高PTH 组患者有较高的透析前血清总钙、磷、肌酐、碱性磷酸酶、白蛋白、前白蛋白、铁蛋白以及全血铅水平，余微量元素在两组间无统计学差异。多因素Logistic回归分析结果显示，较高的透析前血清总钙、血清磷、较高的骨化三醇使用率及全血铅高于中位数44.3μg/L 是MHD 患者血清PTH≥300pg/ml 的独立相关因素(OR 值分别为13.646，2.859，3.400，2.655；95% CI 分别为1.470～126.649，1.442～5.667，1.470～7.863，1.162～6.113；P 值分别为0.022，0.003，0.004，0.021)。结论MHD 患者全血铅＞44.3μg/L 和血清PTH≥300pg/ml 独立相关，值得临床关注并进一步进行相关研究。

关键词: 维持性血液透析, 甲状旁腺激素, 全血铅, 全血微量元素

Abstract: 【Abstract】Objectives To investigate the correlation between whole blood trace elements and serum parathyroid hormone (PTH) in maintenance hemodialysis (MHD) patients. Method This was a cross-section and singlEcenter study. A total of 153 MHD patients treated during September 2019 in our center were enrolled in this study. Their clinical data and drug usage were collected. Laboratory parameters and blood trace elements were measured before dialysis. According to serum PTH level, patients were divided into high PTH group (PTH≥300pg/ml, n=46) and the low PTH group (PTH<300pg/ml, n=107). Clinical characteristics were
compared between the two groups. Univariate and multivariate logistic regressions were utilized to analyze the factors relating to the high PTH level. Results Compared with the patients in the low PTH group, those in the high PTH group had higher prEdialysis levels of serum calcium, phosphorus, creatinine, alkaline phosphatase, albumin, prealbumin, ferritin and whole blood lead, but had no significant differences in other trace elements. Multivariate binary logistic regression showed that higher levels of serum calcium and phosphorus, use of calcitriol and blood lead>44.3μg/L were independently correlated with the higher serum PTH. Conclusion
Whole blood lead >44.3μg/L was independently correlated with the serum PTH≥300pg/ml in MHD patients.

Key words: Maintenance hemodialysis, Parathyroid hormone, Whole blood lead, Whole blood trace elements

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