维持性血液透析合并难治性继发性甲状旁腺功能亢进患者甲状旁腺激素水平与骨密度的关系

doi:10.16138/j.1673-6087.2021.01.010

摘要/Abstract

关键词: 维持性血液透析, 难治性继发性甲状旁腺功能亢进, 甲状旁腺激素, 骨密度

中图分类号:

R457

占志朋, 谢席胜, 张凌. 维持性血液透析合并难治性继发性甲状旁腺功能亢进患者甲状旁腺激素水平与骨密度的关系[J]. 内科理论与实践, 2021, 16(01): 45-48.

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参考文献 18

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项目	数值
男性/女性（n）	77/82
年龄(岁)	49.4±10.8
透析龄(月)	89.3 (61.8,119.8)
体质量指数(kg/m²)	23.0±4.1
血钙(mmol/L)	2.6±0.2
血磷(mmol/L)	2.3±0.6
iPTH (ng/L)	1 727.8 (1 170.8,2 470.8)
ALP(U/L)	200.0 (145.0,459.0)
25羟维生素D (nmol/L)	40.0 (29.0,47.5)
Alb(g/L)	44.2±4.1
腰椎L1~L4 BMD(g/cm²)	1.1±0.2
股骨颈BMD (g/cm²)	0.8±0.1
全髋BMD (g/cm²)	0.8±0.2

项目	腰椎L1-L4		股骨颈		全髋
项目	β（95%CI）	P	β（95%CI）	P	β（95%CI）	P
iPTH/100	-0.008(-0.012~-0.004)	<0.001	-0.004(-0.007~-0.002)	0.002	-0.006(-0.010~-0.003)	<0.001
分组
Q1	1.000		1.000		1.000
Q2	-0.005(-0.088~0.078)	0.900	0.027(-0.029~0.083)	0.342	0.011(-0.055~0.077)	0.743
Q3	-0.006(-0.089~0.077)	0.890	0.018(-0.040~0.077)	0.543	0.003(-0.064~0.070)	0.923
Q4	-0.149(-0.232~-0.066)	<0.001	-0.063(-0.119~-0.006)	0.030	-0.118(-0.184~-0.051)	<0.001

变量	β	95%CI	P
腰椎BMD
iPTH/100≤23.344	-0.002	-0.008~0.004	0.557
iPTH/100>23.344	-0.022	-0.033~-0.010	<0.001
股骨颈BMD
iPTH/100≤18.25	0.003	-0.004~0.009	0.472
iPTH/100>18.25	-0.009	-0.014~-0.004	<0.001
全髋BMD
iPTH/100≤18.973	0.002	-0.006~0.009	0.622
iPTH/100>18.973	-0.013	-0.019~-0.007	<0.001

	模型1			模型2
	β（95%CI）	P		β（95%CI）	P
腰椎BMD
iPTH/100	-0.007(-0.011, -0.002)		0.004	-0.008(-0.013, -0.002)	0.007
iPTH/100≤18	0.005(-0.007, 0.017)		0.394	0.001(-0.013, 0.015)	0.868
iPTH/100>18	-0.014(-0.021, -0.006)		<0.001	-0.013(-0.022, -0.004)	0.008
股骨颈BMD
iPTH/100	-0.003(-0.006, -0.000)		0.041	-0.005(-0.009, -0.001)	0.021
iPTH/100≤18	0.005(-0.002, 0.013)		0.184	0.004(-0.005, 0.014)	0.376
iPTH/100>18	-0.008(-0.013, -0.003)		0.003	-0.010(-0.016, -0.003)	0.003
全髋BMD
iPTH/100	-0.005(-0.008, -0.002)		0.006	-0.007(-0.011, -0.003)	0.001
iPTH/100≤18	0.006(-0.003, 0.015)		0.221	0.002 (-0.008, 0.012)	0.713
iPTH/100>18	-0.017(-0.030, -0.004)		0.014	-0.013 (-0.020, -0.006)	<0.001

维持性血液透析合并难治性继发性甲状旁腺功能亢进患者甲状旁腺激素水平与骨密度的关系

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