目的了解黄山市维持性血液透析(MHD)患者的现状。方法对2015年9月在黄山市人民医院治疗、透析龄3个月以上的154例MHD患者进行现况调查,分析患者年龄、性别等分布情况,检测、记录、计算患者透析前肌酐、透析龄、血红蛋白、血清钙、血清磷水平、钙磷乘积、全段甲状旁腺激素(iPTH)水平。结果154例患者中,男89例(57.79%),女65例(42.21%),男女比例为1.37 ∶1;年龄≤60岁者78例,>60岁者76例;原发病前3位分别为慢性肾小球肾炎74例(48.1%)、糖尿病肾病33例(21.4%)、高血压肾损害19例(12.3%);Hb<110 g/L 者146例(94.81%),Hb≥110 g/L者8例(5.19%);血钙2.1~2.37 mmol/L者37例(24.01%);血磷1.13~1.78 mmol/L者65例(42.21%);钙磷代谢紊乱(高钙、低钙、高磷、低磷)139例(90.26%),钙磷乘积>4.52 mmol2/L2者23例(14.94%);iPTH最低者仅2.213 ng/L,最高者达3 285.77 ng/L,<150 ng/L者41例(26.6%),150~600 ng/L者90例(58.4%),>600 ng/L者23例(14.9%)。结论维持性血液透析患者男性较女性略多,发病年龄年轻化,慢性肾小球肾炎仍是终末期肾脏病的第1位病因;MHD患者Hb达标率极低,钙磷代谢紊乱及继发性甲状旁腺功能亢进患者比较多见。
ObjectiveTo investigate the present situation of patients on maintenance hemodialysis(MHD) in Huangshan. MethodsA total of 154 patients received MHD in the people’s hospital of Huangshan during September, 2015 were selected, all patients had received MHD for more than 3 months, age, gender, dialysis age, Hb, serum Ca, serum phosphate, CaxP product and serum iPTH of all patients were recorded and analyzed. ResultsThere were 89 males(57.79%) and 65 females (42.21%),with the male to female ratio of 1.37 ∶1; 78 cases of patient were younger than or equal to 60 years old and 76 patients were over 60 years old; the top three disease etiologies were chronic glomerulonephritis (74 cases, 48.1%),diabetic nephropathy (33 cases, 21.4%),hypertensive renal damage(19 cases, 12.3%); Hb less than l10g/L were in 146 patients (94.81%),Hb≥l10 g/L were in 8 patients (5.19%);the blood calcium of 37patients (24.01%) was from 2.1 to 2.37 mmol/L; serum phosphate of 65 patients (42.21%) was from 1.13 to 1.78 mmol/L;139 patients (90.26%) in disorder of calcium phosphate metabolism (including hypercalcemia,hypocalcemia,hyperphosphatemia and hypophosphatemia), the calcium-phosphorus product>4.52 mmol2/L2 were in 23 patients(14.94%); the lowest iPTH was only 2.213 ng/L, and the highest was 3285.77ng/L, iPTH<150 ng/L were in 41 patients(26.6%), the iPTH of 90 patients (58.4%) was 150 to 600ng/L, iPTH>600 ng/L were in 23 patients (14.94%). ConclusionsMHD patients are more males than females,the uremic patients tended to be younger, chronic glomerulonephritis is the first pathogeny of ERSD; MHD patients has low standard-reaching rate of Hb, disorder of calcium phosphate metabolism and secondary hyperparathyroidism are found more.