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目的:探讨我科长期规律血液透析患者血清25羟维生素D水平变化及其与骨密度的关系。方法:选取广仁医院血液净化中心2015年1月至10月规律血液透析患者90例,分为糖尿病肾病透析组和非糖尿病肾病透析组,分别检测血清25羟维生素D、甲状旁腺素(PTH)、血钙、血磷等指标,测定其骨密度值,并分析两组间各指标的差异及25羟维生素D水平与骨密度值之间的关系。结果:两组骨密度值及25羟维生素D水平均下降,且糖尿病肾病透析组骨密度与血清25羟维生素D水平明显低于非糖尿病肾病透析组(P<0.05),两组血钙、血磷水平差异无统计学意义(P>0.05)。相关性分析显示透析患者骨密度值与25羟维生素D水平呈线性正相关关系(P<0.05)。结论:我科长期血液透析患者均出现骨质代谢紊乱,骨密度及25羟维生素D水平在糖尿病肾病透析患者中更低。
Objective: To investigate the changes of serum 25-hydroxyvitamin D level and its relationship with bone mineral density in long-term hemodialysis patients in our department. Methods Ninety hemodialysis patients from January 2015 to October 2015 in Guangren Hospital were divided into two groups: diabetic nephropathy dialysis group and non-diabetic nephropathy dialysis group. Serum levels of 25-hydroxyvitamin D, parathyroid hormone (PTH) ), Blood calcium, phosphorus and other indicators, measured the value of bone mineral density, and analysis of the differences between the two groups of indicators and 25-hydroxy vitamin D levels and bone mineral density values. Results: The bone mineral density and 25-hydroxyvitamin D decreased in both groups, and the bone mineral density and serum 25-hydroxyvitamin D levels were significantly lower in dialysis diabetic nephropathy group than those in non-diabetic nephropathy dialysis group (P <0.05) There was no significant difference in phosphorus level (P> 0.05). Correlation analysis showed that there was a linear positive correlation between BMD and 25-OHd level in dialysis patients (P <0.05). CONCLUSION: In our long-term hemodialysis patients, there is disorder of bone metabolism. BMD and 25-hydroxyvitamin D levels are lower in dialysis patients with diabetic nephropathy.