慢性肾功能不全血磷、PTH与桡动脉硬化的相关性

目的 探讨血磷、甲状旁腺素(PTH)与慢性肾功能不全(CRI)4～5期患者桡动脉硬化的关系.方法 CRI 4～5期患者62例,根据血磷水平分为两组,50例血磷水平≥1.48 mmol/L为A组50例,12例血磷水平＜1.48 mmol/L为B组;根据PTH水平分为C、D组,39例PTH≥88 pg/ml为C组,23例PTH＜88 pg/ml为D组.分析比较各组透析术前年龄、病程、血磷、血钙、PTH、甘油三脂(TG)、胆固醇(CHO)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、血肌酐(Cr)、尿素氮(BUN)、体重指数(BMI)、血压(BP)及术后桡动脉病变评分(RAAG),分析血磷、PTH等与患者桡动脉硬化的相关性.结果 4组间TG、CHO、LDL、HDL、Cr、BUN、BMI、BP水平差异无统计学意义(P＞0.05);A、B组间和C、D组间比较,血磷、PTH、病程、钙磷乘积、动脉硬化评分有统计学差异(P＜0.05或P＜0.01);多元回归分析显示,高PTH、高血磷与RAAG有显著相关性(r=0.781,0.214,P＜0.01),血磷与PTH无明显相关性(P＞0.05).结论 CRI 4～5期患者桡动脉硬化与高PTH、高血磷水平密切相关,控制血PTH、血磷水平可降低CRI患者桡动脉硬化的风险.

Correlation among serum phosphorus,parathyroid hormone and radial arterial sclerosis in patients with chronic renal insufficiency

Objective To discuss the correlation among serum phosphorus,parathyroid hormone（PTH）and radial arterial sclerosis in patients with chronic renal insufficiency（CRI 4-5 stage）.Methods Sixty two patients with CRI in 4-5 stage were divided into two groups according to the serum phosphorus level.The serum phosphorus level of patients in group A was over or equal to 1.48 mmol/L（50 cases）,and that of patients in group B was lower than 1.48 mmol/L（12 cases）.In addition,these patients were divided into group C and D according to the PTH level.The PTH level of patients in group C was over or equal to 88 pg/ml（39 cases）,and that of patients in group D was lower than 88 pg/ml（23 cases）.Comparison was made among the groups in aspects of age,course of disease,serum phosphorus,blood calcium,PTH,triglyceride（TG）,cholesterol（CHO）,low density lipoprotein（LDL）,high density lipoproteins（HDL）,serum creatinine（Cr）,blood urea nitrogen（BUN）,body mass index（BMI）,and blood pressure（BP）before the dialysis and the radial artery atherosclerotic grade（RAAG）after the dialysis.The correlation between serum phosphorus and PTH and the radial arterial sclerosis was analyzed.Results There was no significant difference in TG,CHO,LDL,HDL,Cr,BUN,BMI and BP among the four groups（P0.05）.There were significant differences in serum phosphorus,PTH,course of disease,calcium-phosphorus product and arteriosclerosis grades,respectively,between group A and B and group C and D（P0.05 or P0.01）.The multiple regression analysis showed that there was obvious correlation between PTH and serum phosphorus and RAAG（r=0.781,0.214,P0.01）,but there was no obvious correlation between serum phosphorus and PTH（P0.05）.Conclusion There is a close correlation between radial arterial sclerosis and levels of PTH and serum phosphorus in patients with CRI in 4-5 stage.Control of PTH and serum phosphorus may reduce the risk of radial arterial sclerosis in patients with CRI.