中国血液净化

中国血液净化 ›› 2015, Vol. 14 ›› Issue (06): 325-327.doi: 10.3969/j.issn.1671-4091.2015.06.002

• 临床研究 • 上一篇    下一篇

维持性血液透析患者骨密度异常相关因素分析

路凌,孟娜娜,金超群,任莉   

  1. 陕西核工业215医院血液透析中心
  • 收稿日期:2015-03-16 修回日期:2015-04-09 出版日期:2015-06-12 发布日期:2015-05-29
  • 基金资助:

    咸阳市重大科技计划项目(2013K1201)

Analyses on the factors relating to the abnormal bone mineral density in maintenance hemodialysis patients

  • Received:2015-03-16 Revised:2015-04-09 Online:2015-06-12 Published:2015-05-29

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摘要： 【摘要】目的观察维持性血液透析患者骨密度异常发生情况，分析骨密度异常与年龄、性别、透析时间以及骨代谢异常相关因素iPTH、钙、磷的关系。方法①采用横断面调查方法观察维持性血液透析患者年龄、性别、透析龄及相关生化指标，采用定量超声检查法，测量263 例维持性血液透析患者骨密度(BMD) 值；②.采用pearson 相关分析及Logistic 回归方法分析年龄、性别、透析时间及骨代谢相关生化指标对骨质疏松的影响。结果①维持性血液透析患者中，骨密度异常占90.12%，其中骨质疏松者占45.62%，低骨量者占44.48%，正常骨量占9.88%。②年龄与骨密度值呈负相关(r =-0.242，P =0.000)，随着年龄的增长，骨质疏松发生的危险性增加1.352 倍；女性骨质疏松发生率(58.62%)较男性(34.69%)明显增高，差异有统计学意义(χ2=14.980，P =0.000)，女性发生骨质疏松的危险性是男性的2.46 倍；透析龄与骨密度值呈负相关(r =-0.198，P =0.030)；随着血磷的升高，骨质疏松发生的危险性增加1.33 倍。③维持性血液透析患者中，骨密度值与血钙、血磷、血iPTH 无相关性, 将患者的年龄、性别、血清钙、血清磷、血iPTH 等数据引入Logistic 回归模型，筛选出年龄、性别、血磷为最终影响预后的因素，女性、高龄以及高磷血症为患者骨质疏松的危险因素。结论维持性血液透析患者骨密度异常发生率高，年龄、女性、透析龄以及高磷血症均是发生骨质疏松的危险因素。

关键词: 维持性血液透析, 骨密度(BMD)

Abstract: 【Abstract】Objective To observe the abnormal bone mineral density (BMD) in maintenance hemodialysis (MHD) patients, and to correlate BMD with age, sex, dialysis vintage, and bone metabolic related indicators including serum iPTH, calcium and phosphorus. Methods This was a cross-sectional study to measure
BMD value by quantitative ultrasound in 263 MHD patients and to observe their age, gender, dialysis vintage, and bone metabolism related indicators. Results ①Abnormal BMD was found in 90.12% MHD patients, including osteoporosis in 45.62% patients and low bone mass in 44.48% patients. ②Age was negatively correlated with BMD value (r=-0.242, P=0.000). The risk of osteoporosis increased 1.352 folds with the increase of age. The prevalence of osteoporosis was 58.62% in females significantly higher than that in males (34.69%; χ2=14.980, P=0.000). The risk of osteoporosis in females was 2.46 times higher than that in males. Hemodialysis vintage was negatively correlated with BMD value (r=-0.198, P=0.198). The risk of osteoporosis increased 1.33 folds with the increase of serum phosphorus. Conclusion The prevalence of abnormal BMD was higher in MHD patients. Age, female, hemodialysis vintage and hyperphosphatemia were the risk factors for osteoporosis.

Key words: Maintenance hemodialysis, Bone mineral density