[1]章 玉,莫立稳,张青云,等.维持性血液透析患者钙磷代谢紊乱\与营养-炎症状态相关性分析[J].陕西医学杂志,2024,(9):1197-1201.[doi:DOI:10.3969/j.issn.1000-7377.2024.09.009]
　ZHANG Yu,MO Liwen,ZHANG Qingyun,et al.Correlation analysis of calcium-phosphorus metabolism disorder with nutritional-inflammatory status in patients with maintenance hemodialysis[J].,2024,(9):1197-1201.[doi:DOI:10.3969/j.issn.1000-7377.2024.09.009]
点击复制

维持性血液透析患者钙磷代谢紊乱\与营养-炎症状态相关性分析
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年9期
页码:
1197-1201
栏目:
临床研究
出版日期:
2024-09-05

文章信息/Info

Title:
Correlation analysis of calcium-phosphorus metabolism disorder with nutritional-inflammatory status in patients with maintenance hemodialysis
作者:
章 玉; 莫立稳; 张青云; 唐婉琴; 范晓栋
(解放军西部战区总医院肾脏病科,四川 成都 610057)
Author(s):
ZHANG Yu; MO Liwen; ZHANG Qingyun; TANG Wanqin; FAN Xiaodong
(Department of Nephrology,Western Theater General Hospital,Chengdu 610057,China)
关键词:
维持性血液透析;  钙磷代谢;  全段甲状旁腺激素;  营养-炎症状态;  营养不良-炎症评分;  相关性分析
Keywords:
Maintenance hemodialysis;  Calcium-phosphorus metabolism;  Intact parathyroid hormone;  Nutritional-inflammatory status;  Malnutrition-Inflammation Score;  Correlation analysis
分类号:
R 692.5
DOI:
DOI:10.3969/j.issn.1000-7377.2024.09.009
文献标志码:
A
摘要:
目的:分析维持性血液透析(MHD)患者钙磷代谢紊乱与营养-炎症状态的相关性。方法:选取接受MHD治疗的患者513例,检测血清钙磷代谢指标[血磷(P)、血钙(Ca)、全段甲状旁腺激素(iPTH)、钙磷乘积]和营养-炎症状态指标[白蛋白(ALB)、血红蛋白(Hb)、体重指数(BMI)、高敏C-反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)],采用营养不良-炎症评分(MIS)评估患者营养-炎症状态。根据血清钙、磷水平将患者分为钙磷代谢紊乱组和钙磷代谢正常组,根据MIS评分将患者分为营养不良组和非营养不良组,比较上述指标的组间差异。采用Pearson法分析MHD患者钙磷代谢与营养-炎症状态指标的相关性。结果:钙磷代谢紊乱组P、iPHT、钙磷乘积高于钙磷代谢正常组,Ca低于钙磷代谢正常组(均P<0.05)。钙磷代谢紊乱组ALB、Hb、BMI低于钙磷代谢正常组,hs-CRP、TNF-α、IL-6和MIS评分高于钙磷代谢正常组(均P<0.05)。营养不良组P、iPHT、钙磷乘积高于非营养不良组,Ca低于非营养不良组(均P<0.05)。营养不良组ALB、Hb、BMI低于非营养不良组,hs-CRP、TNF-α、IL-6和MIS评分高于非营养不良组(均P<0.05)。Pearson相关分析结果显示,P、iPHT、钙磷乘积与ALB、HB、BMI呈负相关,与hs-CRP、TNF-α、IL-6、MIS评分呈正相关; Ca与ALB、HB、BMI呈正相关,与hs-CRP、TNF-α、IL-6、MIS评分呈负相关(均P<0.05)。结论:MHD患者钙磷代谢紊乱与营养-炎症状态相关。
Abstract:
Objective:To analyze the correlation between calcium-phosphorus metabolism disorder and nutritional-inflammatory status in patients undergoing maintenance hemodialysis(MHD).Methods:A total of 513 patients who underwent MHD were selected.Serum phosphorus(P),serum calcium(Ca),intact parathyroid hormone(iPTH),calcium-phosphorus product and albumin(ALB),hemoglobin(Hb),Body Mass Index(BMI),high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)were detected,and Malnutrition-Inflammation Score(MIS)was used to evaluate the nutritional-inflammatory status of patients.According to the levels of serum calcium and phosphorus,the patients were classified into calcium-phosphorus metabolism disorder group and normal calcium-phosphorus metabolism group.By means of the MIS score,the patients were divided into malnutrition group and non-malnutrition group.The differences in the above indicators were compared.Pearson correlation coefficient was performed to analyze the correlation between calcium-phosphorus metabolism and nutritional-inflammatory status indicators in MHD patients.Results:The P,iPHT and calcium-phosphorus product in calcium-phosphorus metabolism disorder group were higher than those in normal calcium-phosphorus metabolism group,while the Ca was lower than that in normal calcium-phosphorus metabolism group(all P<0.05).The ALB,Hb and BMI were lower while the hs-CRP,TNF-α,IL-6 and MIS score in calcium-phosphorus metabolism disorder group were higher than those in normal calcium-phosphorus metabolism group(all P<0.05).The P,iPHT and calcium-phosphorus product in malnutrition group were higher while the Ca was lower compared to non-malnutrition group(all P<0.05).The ALB,Hb and BMI in malnutrition group were lower than those in non-malnutrition group while the hs-CRP,TNF-α,IL-6 and MIS score were higher(all P<0.05).Pearson correlation analysis showed that P,iPHT and calcium-phosphorus product were negatively correlated with ALB,HB and BMI,and positively correlated with hs-CRP,TNF-α,IL-6 and MIS score; Ca was positively correlated with ALB,HB and BMI,and negatively correlated with hs-CRP,TNF-α,IL-6 and MIS score(all P<0.05).Conclusion:Calcium-phosphorus metabolism disorder in MHD patients is related to the nutritional-inflammatory status.

参考文献/References:

[1] WANG L,XU X,ZHANG M,et al.Prevalence of chronic kidney disease in China:Results from the sixth China chronic disease and risk factor surveillance[J].JAMA Intern Med,2023,183(4):298-310.
[2] 方修移,吴小冬,潘美娟,等.罗沙司他治疗慢性肾脏病合并肾性贫血临床价值研究[J].陕西医学杂志,2024,53(5):666-670.
[3] 王禹霖,刘梦超,郑冰洁,等.名中医张炳厚从瘀论治慢性肾脏病经验撷英[J].陕西中医,2023,44(11):1602-1605.
[4] GRATEROL-TORRES F,MOLINA M,SOLER-MAJORAL J,et al.Evolving concepts on inflammatory biomarkers and malnutrition in chronic kidney disease[J].Nutrients,2022,14(20):4297.
[5] 姚向飞,刘华,蔡东,等.铁蛋白、钙、磷、甲状旁腺激素水平与维持性血液透析患者预后关系研究[J].陕西医学杂志,2023,52(3):297-300,304.
[6] NAGY E,MAHMOUD M,EL-KANNISHY G,et al.Impact of malnutrition on health-related quality of life in patients on maintenance hemodialysis[J].Ther Apher Dial,2021,25(4):467-474.
[7] 郝静,夏京华.加味桃红四物汤联合左卡尼汀对维持性血液透析患者营养状况的影响[J].陕西中医,2021,42(7):903-906.
[8] 黄梦娣,陈卫东,刘磊.维持性血液透析患者血清碱性磷酸酶与钙磷代谢及炎症指标相关性分析[J].中华全科医学,2023,21(4):611-614.
[9] 中国医师协会肾脏病医师分会血液透析充分性协作组.中国血液透析充分性临床实践指南[J].中华医学杂志,2015,95(34):2748-2753.
[10] 刘志红,李贵森.中国慢性肾脏病矿物质和骨异常诊治指南[M].北京:人民卫生出版社,2019:9-16.
[11] KALANTAR-ZADEH K,KOPPLE J D,HUMPHREYS M H,et al.Comparing outcome predictability of markers of malnutrition-inflammation complex syndrome in haemodialysis patients[J].Nephrol Dial Transplant,2004,19(6):1507-1519.
[12] ASHABI A,TABIBI H,NOZARY-HESHMATI B,et al.Comparison of various scoring methods for the diagnosis of protein-energy wasting in hemodialysis patients[J].Int Urol Nephrol,2014,46(5):999-1004.
[13] 李京,王怡,李霞.血液透析联合血液灌流治疗对慢性肾病患者钙磷和脂质代谢的影响[J].重庆医学,2020,49(9):1409-1412.
[14] ZHANG H,LI G,YU X,et al.Progression of vascular calcification and clinical outcomes in patients receiving maintenance dialysis[J].JAMA Netw Open,2023,6(5):e2310909.
[15] XU J,SHEN C J,OOI J D,et al.Serum sortilin is associated with coronary artery calcification and cardiovascular and cerebrovascular events in maintenance hemodialysis patients[J].Kidney Dis(Basel),2021,7(6):503-513.
[16] 上海市肾内科临床质量控制中心专家组.慢性肾脏病早期筛查、诊断及防治指南(2022年版)[J].中华肾脏病杂志,2022,38(5):453-464.
[17] TAO S,LI X,LIU Z,et al.Investigation on maintenance hemodialysis patients with mineral and bone disorder in Anhui Province,China[J].Int Urol Nephrol,2023,55(2):389-398.
[18] 仇思傲,杨家慧,王蓓.维持性血液透析患者营养状况及影响因素研究[J].华南预防医学,2022,48(1):81-83.
[19] SETHI S,SETHI N,MAKKAR V,et al.Malnutrition-inflammation score:A valid tool to assess nutritional status in patient with end-stage renal disease[J].Saudi J Kidney Dis Transpl,2022,33(4):559-565.
[20] WRIGHT M,SOUTHCOTT E,MACLAUGHLIN H,et al.Clinical practice guideline on undernutrition in chronic kidney disease[J].BMC Nephrol,2019,20(1):370.
[21] 徐维,袁立英,喻海燕.前列地尔联合肾康注射液对维持性血液透析老年患者微炎症状态的影响[J].中国老年学杂志,2021,41(19):4308-4311.
[22] 张笑浩,唐方林,饶嘉玲,等.指尖血红蛋白分析仪在维持性血液透析患者中应用的准确性[J].中华肾脏病杂志,2024,40(1):49-52.
[23] 黄岩,常晶,王华敏,等.维持性血液透析老年患者蛋白质能量消耗对衰弱的影响[J].中华老年医学杂志,2023,42(5):504-508.
[24] 李倩,邓开慧,龙艳君,等.维持性血液透析患者蛋白质能量消耗的影响因素[J].中华医学杂志,2019,99(20):1567-1571.
[25] 靳政玺,黎曼,王红梅,等.益生菌对维持性血液透析的慢性便秘患者肠道菌群及生存质量的影响[J].中国血液净化,2022,21(4):244-248.
[26] MASON D L,GODUGU K,NNANI D,et al.Effects of sevelamer carbonate versus calcium acetate on vascular calcification,inflammation,and endothelial dysfunction in chronic kidney disease[J].Clin Transl Sci,2022,15(2):353-360.
[27] 张帆,江杨,龚宇,等.血液透析滤过对终末期肾病患者钙磷代谢及心血管并发症的影响[J].中国实验诊断学,2023,27(1):17-20.

相似文献/References:

[1]朱昭章,卢 岚,周凡力△.中青年维持性血液透析患者轻度认知功能损害与透析间低血压相关性研究*[J].陕西医学杂志,2020,49(3):300.
　ZHU Zhaozhang,Lu Lan,ZHOU Fanli..Clinical study on the relationship between mild cognitive impairment and intradialytic hypotension in young and middle-aged maintenance hemodialysis patients[J].,2020,49(9):300.
[2]王佳莹,谭 峰,吴宸极,等.维持性血液透析伴继发性甲状旁腺功能亢进患者甲状旁腺切除术后骨饥饿综合征发生影响因素及血清离子变化特征[J].陕西医学杂志,2021,50(3):334.[doi:DOI:10.3969/j.issn.1000-7377.2021.03.020]
[3]张 媛,朱小静.维持性血液透析患者骨硬化蛋白、Klotho蛋白水平变化及与冠状动脉钙化相关性分析[J].陕西医学杂志,2021,50(10):1246.[doi:DOI:10.3969/j.issn.1000-7377.2021.10.017]
　ZHANG Yuan,ZHU Xiaojing.Changes of bone sclerostin and Klotho protein levels in maintenance hemodialysis patients and their correlation with coronary artery calcification[J].,2021,50(9):1246.[doi:DOI:10.3969/j.issn.1000-7377.2021.10.017]
[4]姚向飞,刘 华,蔡 东,等.铁蛋白、钙、磷、甲状旁腺激素水平与维持性血液透析患者预后关系研究[J].陕西医学杂志,2023,52(3):297.[doi:DOI:10.3969/j.issn.1000-7377.2023.03.011]
　YAO Xiangfei,LIU Hua,CAI Dong,et al.Relationship between ferritin,calcium,phosphorus,parathyroid hormone levels and prognosis of patients with maintenance hemodialysis[J].,2023,52(9):297.[doi:DOI:10.3969/j.issn.1000-7377.2023.03.011]
[5]邱 瑛,杨玉洁,袁怀红.维持性血液透析患者皮肤瘙痒临床研究进展[J].陕西医学杂志,2023,52(6):775.[doi:DOI:10.3969/j.issn.1000-7377.2023.06.031]
　QIU Ying,YANG Yujie,YUAN Huaihong.Clinical research progress of pruritus in patients undergoing maintenance hemodialysis[J].,2023,52(9):775.[doi:DOI:10.3969/j.issn.1000-7377.2023.06.031]
[6]程 莉,章晓良,吴福杉,等.血清正五聚蛋白3、三叶因子3水平对维持性血液透析患者预后转归的预测价值[J].陕西医学杂志,2023,52(7):814.[doi:DOI:10.3969/j.issn.1000-7377.2023.07.008]
　CHENG Li,ZHANG Xiaoliang,WU Fushan,et al.Predictive value of serum PTX3 and TFF3 levels for prognosis of patients with maintenance hemodialysis[J].,2023,52(9):814.[doi:DOI:10.3969/j.issn.1000-7377.2023.07.008]
[7]任 翔,过轶斌,张立元.罗沙司他对重组人促红细胞生成素疗效不佳血液透析肾性贫血患者血生化、铁代谢和钙磷代谢的影响[J].陕西医学杂志,2023,52(7):902.[doi:DOI:10.3969/j.issn.1000-7377.2023.07.029]
　REN Xiang,GUO Yibin,ZHANG Liyuan.Effect of roxadustat on blood biochemistry,iron metabolism and calcium-phosphorus metabolism in patients undergoing hemodialysis for renal anemia inadequately controlled by rHuEPO[J].,2023,52(9):902.[doi:DOI:10.3969/j.issn.1000-7377.2023.07.029]
[8]吕 宁,杨立娟,尹林林,等.血清可溶性CD40配体、腱糖蛋白C、甲壳质酶蛋白-40联合检测对维持性血液透析并发心血管事件的预测作用[J].陕西医学杂志,2025,54(1):123.[doi:DOI:10.3969/j.issn.1000-7377.2025.01.025]
　LV Ning,YANG Lijuan,YIN Linlin,et al.Effect of serum sCD40L,TN-C and YKL-40 combined detection on cardiovascular events during maintenance hemodialysis[J].,2025,54(9):123.[doi:DOI:10.3969/j.issn.1000-7377.2025.01.025]

备注/Memo

备注/Memo:
基金项目:四川省自然科学基金资助项目(2023NSFSC0602)
更新日期/Last Update: 2024-09-04