残余肾功能对维持性血液透析患者钙磷代谢紊乱和左心室肥厚影响的临床分析-内科肾脏病学专业论文.docxVIP

广州医学院硕士学位论文 广州医学院硕士学位论文 IV IV Abstract Objective：To explore the effect of residual renal function on calcium and phosphorus metabolism and left ventricular hypertrophy in hemodialysis patients.Methods:158 cases of hemodialysis maintenance hemodialysis (MHD) patients were cross-sectional studied in Shenzhen Second Peoples Hospital on February 2011.We assessed glomerular filtration rate (GFR) by urea clearance. GFR 1ml/min/1.73m2 were defined as positive residual renal function（RRF）,then we divided MHD patients into group A（With RRF）and group B（Without RRF）by this limit. The main biochemical indicators we concerned were serum calcium, phosphorus, calcium and phosphorus product, parathyroid hormone (PTH). We examined left ventricular posterior wall diastolic thickness, interventricular septum thickness, E/A, ejection fraction echocardiography,and calculated left ventricular mass index (LVMI) using Devereux formula. Statistical Methods we used were t-test of two sample, χ2 test, multiple linear regression analysis, linear correlation (Pearson correlation coefficient). Results: (1) There were 60 patients owned RRF ,accounting for 37.97%.GFR was 2.96 ± 1.95ml/min/1.73m2. (2) The level of serum phosphate（1.54±0.55 mmol/L）, PTH（356.11±271.15 pg/ml）of group A were significantly lower than that of group B （2.18±0.67 mmol/L，577.68±416.04pg/ml), and the level of corrected serum calcium （group A 2.26±0.25 mmol/L vs group B 2.01±0.34 mmol/L，P 0.091）, calcium and phosphorus product（group A 3.49±0.51 mmol2/L 2 vs group B 4.28±0.66 mmol2/L 2 ，P 0.062）was no significant difference. (3) The multiple linear regression analysis of factors that affect phosphorus showed that duration of hemodialysis（β=0.32，P =0.005）, albumin（β=0.15，P =0.046） and serum phosphate levels are positive correlation. However, GFR was negatively correlated with serum phosphate levels.（β=－0.180, P =0.043）(4) Hemodialysis patients with left ventricular hypertrophy(LVH) accounted for 88.61 percent.Patients