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目的:通过分析血液透析患者踝臂指数(ABI)与血磷水平相关性,为临床下肢外周动脉病(PAD)的防治提供重要依据。方法:以本院2015年1月至2015年12月收治的200例终末期肾病维持性血液透析患者为研究对象,均行ABI测量,根据ABI测量结果将患者分为合并PAD组(ABI<0.9,40例)与非PAD组(ABI≥0.9,160例),测定并比较两组血脂、血压、血清肌酐、血磷、血钙等指标。结果:两组血压、血糖、血脂、血清肌酐、尿素氮各指标比较差异无统计学意义(P>0.05)。PAD组血磷、钙磷乘积、全段甲状旁腺素(iPTH)、超敏C反应蛋白(hsCRP)水平分别为(2.08±0.32)mmol/L、(56.4±5.6)mg~2/dL~2、(413.2±235.1)pg/m L、(8.0±1.2)mg/L,均明显高于非PAD组的(1.65±0.49)mmol/L、(44.1±8.8)mg~2/dL~2、(208.8±172.5)pg/m L、(3.5±1.3)mg/L(P<0.01)。Logistic回归分析血磷、钙磷乘积、i PTH及hs CRP是影响ABI的独立因素。结论:高磷血症、高i PTH及微炎症状态参与血液透析患者PAD发病进程。
OBJECTIVE: To provide an important basis for prevention and treatment of clinical lower extremity peripheral arterial disease (PAD) by analyzing the correlation between ankle-brachial index (ABI) and serum phosphorus in hemodialysis patients. Methods: A total of 200 patients with end-stage renal disease who received hemodialysis from January 2015 to December 2015 in our hospital were enrolled in this study. All patients underwent ABI measurement. According to the ABI measurement, patients were divided into two groups: ABI <0.9 , 40 cases) and non-PAD group (ABI≥0.9,160 cases). The levels of serum lipids, blood pressure, serum creatinine, serum phosphorus and serum calcium in the two groups were measured and compared. Results: The blood pressure, blood glucose, blood lipid, serum creatinine and urea nitrogen had no significant difference between the two groups (P> 0.05). The levels of P and P, PTH, iPTH and hsCRP in PAD group were (2.08 ± 0.32) mmol / L and (56.4 ± 5.6) mg ~ 2 / dL ~ 2, (413.2 ± 235.1) pg / m L and (8.0 ± 1.2) mg / L respectively, which were significantly higher than those in non - PAD group (1.65 ± 0.49 mmol / L and 44.1 ± 8.8 mg / , (208.8 ± 172.5) pg / m L, and (3.5 ± 1.3) mg / L respectively (P <0.01). Logistic regression analysis of serum phosphorus, calcium and phosphorus products, i PTH and hs CRP are independent factors affecting ABI. CONCLUSION: Hyperphosphatemia, high i-PTH and micro-inflammatory status are involved in the pathogenesis of PAD in hemodialysis patients.