| 姜俊,王科,王丽华,王艳,胡志伟,赵宸,兰雷,任伟.慢性肾脏病5期未透析患者血清25羟维生素D3水平及相关因素研究[J].中国临床保健杂志,2020,23(1):109-114. |
| 慢性肾脏病5期未透析患者血清25羟维生素D3水平及相关因素研究 |
| The study of the serum 25-hydroxyvitamin D3 level and its correlated factors in non-dialysis patients with stage 5 chronic kidney diseases |
| 投稿时间：2018-07-18 |
| DOI：10.3969/J.issn.1672-6790.2020.01.025 |
| 中文关键词: 肾病 骨化三醇 危险因素 |
| 英文关键词: Nephrosis Calcitriol Risk factors |
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| 中文摘要: |
| 目的 探讨慢性肾脏病(CKD)5期未透析患者的血清25羟维生素D3[25(OH)D3]水平及其相关因素。方法 选取在肾内科住院诊断为CKD 5期未透析的72例患者,回顾性的收集患者人口统计学数据及临床资料,根据血清25(OH)D3水平将患者分为25(OH)D3缺乏组及非缺乏组,比较两组间临床资料的差异。采用spearman相关分析及逐步多元线性回归分析探讨血清25(OH)D3水平的相关因素。采用单因素logistic回归分析探讨血清25(OH)D3缺乏的相关因素,并计算各个相关因素的比值比(OR)及其95%的可信区间(CI)。结果 72例CKD 5期未透析患者血清25(OH)D3水平3.0~38.3 μg/L[平均(8.8±7.0) μg/L],25(OH)D3缺乏组61例,非缺乏组11例,25(OH)D3缺乏率达到84.7%。25(OH)D3缺乏组与非缺乏组在血清钙、磷、碱性磷酸酶、全段甲状旁腺激素、氨基末端B型钠尿肽前体、左心室舒张末期内径、左心室后壁厚度、室间隔厚度、左室射血分数的差异无统计学意义(P均>0.05)。Spearman线性相关分析提示:血清25(OH)D3与血清白蛋白(ρ=0.439)呈正相关(P<0.05),与氨基末端B型钠尿肽前体(ρ=-0.383)、左心室舒张末期内径(ρ=-0.256)呈负相关(P均<0.05)；与血清钙、磷、碱性磷酸酶、全段甲状旁腺激素无相关性(P均>0.05)。逐步多元线性回归分析显示血清25(OH)D3与血清白蛋白呈独立正相关(P<0.05)。单因素logistic回归分析显示仅血清白蛋白<36 g/L (OR=6.058,95% CI:1.206~30.428,P=0.029) 可能是血清25(OH)D3缺乏的危险因素。结论 CKD 5期未透析患者的血清25(OH)D3缺乏可能对CKD 5期未透析患者的心血管疾病有重要影响,而对钙磷代谢的影响比较弱。 |
| 英文摘要: |
| Objective To investigate the serum 25-hydroxyvitamin D3[25(OH)D3] levels and its correlated factors in non-dialysis patients with stage 5 chronic kidney diseases (CKD).Methods A total of 72 non-dialysis patients with stage 5 CKD were selected.The demographic and clinical data of patients were retrospectively collected.According to the 25(OH)D3 level,patients were divided into 25(OH)D3 deficiency group and non-deficiency group.The differences in clinical data between the two groups were compared.Spearman correlation analysis and stepwise multivariate linear regression analysis were used to investigate the correlated factors of serum 25(OH)D3 levels.Univariate logistic regression analysis was used to investigate the correlation factors of serum 25(OH)D3 deficiency,calculate the Odds Ratio (OR) and 95％confidence interval (CI).Results The serum 25(OH)D3 levels in 72 non-dialysis patients with stage 5 CKD were 3.0-38.3 (8.8±7.0)μg/L.There were 61 cases in the 25(OH)D3 deficient group,and 11 cases in the non-deficient group.The deficiency rate of serum 25(OH)D3 reached to 84.7%.There were no statistically significant difference in serum calcium,phosphorus,alkaline phosphatase,parathyroid hormone,N-terminal pro b-type natriuretic peptide (NT-proBNP),left ventricular end-diastolic diameter (LVIDd),left ventricular posterior wall thickness (LVPWTd),interventricular septum thickness (IVSTd),and left ventricular ejection fraction between the two groups (all P>0.05).Spearman linear correlation analysis showed that serum 25(OH)D3 was positively correlated with albumin (ρ=0.439,P<0.05),negatively correlated with NT-proBNP (ρ=-0.383) and LVIDd (ρ=-0.256) (all P<0.05).The serum 25(OH)D3 had no correlation with serum calcium,phosphorus,alkaline phosphatase,and parathyroid hormone (all P>0.05).Stepwise multivariate linear regression analysis showed that serum 25(OH)D3 had independently positive correlation with serum albumin (P<0.05).Univariate logistic regression analysis showed that serum albumin<36 g/L (OR=6.058,95%CI:1.206-30.428,P=0.029) may be risk factor for 25(OH)D3 deficiency.Conclusion The serum 25 (OH) D3 deficiency is common in non-dialysis patients with stage 5 chronic kidney disease,which may play an important role in cardiovascular disease,while its effect on calcium and phosphorus metabolism may be weaker. |
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