维持血液透析患者血清铝负荷及其相关因素研究

发布时间：2018-04-28 04:26

本文选题：血清铝 + 肾功能衰竭　；参考：《中国全科医学》2015年08期

【摘要】：背景铝在人体内的蓄积给维持血液透析患者带来了严重危害,然而目前国内对血液透析患者血清铝水平的大规模调查尚不多见。目的检测福建省慢性肾衰竭维持血液透析患者血清铝水平,探讨影响血清铝水平的因素。方法收集2012年1月—2013年12月福建省厦门市、漳州市、龙岩市、泉州市、三明市15所医院透析中心慢性肾衰竭维持血液透析患者和健康体检者血清标本,共收集慢性肾衰竭维持血液透析患者449例,健康体检者262例,采用AA800原子吸收光谱仪检测血清中铝水平。采用多重线性回归分析影响慢性肾衰竭患者血清铝水平的因素。结果慢性肾衰竭维持血液透析患者血清铝水平为(18.34±6.16)μg/L,高于健康对照者的(1.57±0.45)μg/L(t=2.324,P0.05)。52例(11.6%)慢性肾衰竭维持血液透析患者血清铝水平超过了国际肾脏病组织推荐的慢性肾衰竭患者血清铝允许上限值(30μg/L)。男性慢性肾衰竭维持血液透析患者血清铝水平为(18.45±6.48)μg/L,女性为(18.22±5.64)μg/L,两者比较,差异无统计学意义(t=1.058,P0.05)。各透析中心透析液及所在城市饮用水铝水平比较,差异有统计学意义(F=4.252、3.316,P0.05)。服用磷结合剂、Vit D制剂、注射促红细胞生成素(EPO)及近期接受输血治疗的血液透析患者血清铝水平高于未接受上述治疗患者(P0.05)。慢性肾衰竭维持血液透析患者中不同饮茶量、食加工面食比例者血清铝水平比较,差异有统计学意义(P0.05);不同食肉食比例患者血清铝水平比较,差异无统计学意义(P0.05)。多重线性回归结果显示,饮茶量、面食饮食、饮用水铝含量、每日尿量、透析频率、透析液铝含量、服用磷结合剂、服用Vit D、注射EPO、输血为影响慢性肾衰竭患者血清铝水平的因素(P0.05)。结论福建省慢性肾衰竭维持血液透析患者铝负荷较高,饮食习惯、治疗措施及透析情况影响患者血清铝水平。
[Abstract]:Background the accumulation of aluminum in the human body has brought serious harm to the maintenance of hemodialysis patients, but the large-scale investigation of serum aluminum level of hemodialysis patients in China is still rare. Objective to detect the serum aluminum level in patients with chronic renal failure (CRF) maintenance hemodialysis, and to explore the factors affecting the serum Al level. Methods Serum samples of patients with chronic renal failure (CRF) in dialysis centers of 15 hospitals in Xiamen, Zhangzhou, Longyan, Quanzhou and Sanming from January 2012 to December 2013 were collected. A total of 449 patients with chronic renal failure (CRF) maintained hemodialysis and 262 healthy persons were collected. The serum aluminum levels were measured by AA800 atomic absorption spectrometry (AAS). Multiple linear regression analysis was used to analyze the factors influencing serum aluminum levels in patients with chronic renal failure (CRF). Results the serum aluminum level in patients with chronic renal failure maintenance hemodialysis was 18.34 卤6.16 渭 g / L, which was higher than that in healthy controls (1.57 卤0.45) 渭 g / L, 2.324p 0.05. 52 patients with chronic renal failure (CRF) maintenance hemodialysis patients with chronic renal failure (CRF) was higher than that in patients with chronic renal failure (CRF) recommended by international kidney disease tissue (CRD). The maximum allowable value of serum aluminum was 30 渭 g / L ~ (-1). The serum aluminum level of male patients with chronic renal failure was 18.45 卤6.48 渭 g / L and that of female patients was 18.22 卤5.64 渭 g / L. There was no significant difference between the two groups. The levels of aluminum in dialysate and drinking water in different dialysis centers were significantly different. The serum aluminum level of hemodialysis patients who took phosphorus binding agent Vit D, injected erythropoietin (EPO) and recently received blood transfusion was higher than that of patients without above treatment (P 0.05). The levels of serum aluminum in patients with chronic renal failure (CRF) maintained different amount of tea drinking and the proportion of processed pasta, the difference was statistically significant (P 0.05), but there was no significant difference in the levels of serum Al (P 0.05) in patients with different meat eating ratio. The results of multiple linear regression showed that tea consumption, pasta diet, drinking water aluminum content, daily urine volume, dialysis frequency, dialysate aluminum content, phosphate binder, Taking Vit D, injecting EPO and blood transfusion were the factors influencing serum aluminum level in patients with chronic renal failure (CRF). Conclusion the aluminum load of patients with chronic renal failure in Fujian Province is higher than that of patients with hemodialysis. The dietary habits, treatment measures and dialysis conditions affect the serum aluminum levels of patients with chronic renal failure.
【作者单位】：厦门大学附属第一医院暨福建医科大学教学医院肾内科;厦门大学附属第一医院暨福建医科大学教学医院检验科;
【基金】：国家自然科学基金资助项目(81000762) 福建省自然科学基金资助项目(2010D018) 福建省卫生厅青年基金(2011-2-56)
【分类号】：R692.5

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