肾移植术后高钙血症的发生率及危险因素

发布时间：2018-12-29 15:41

【摘要】：目的:探讨肾移植术后1年内高钙血症的发生率及危险因素,并观察血清钙的演变特点。方法:选取从2013年11月至2015年3月在南京军区南京总医院肾脏科行肾移植手术的受者115例,分别于肾移植术前、术后1个月、3个月、6个月、12个月检测血清钙、全段甲状旁腺激素(iPTH)等矿物质和骨代谢指标。结果:肾移植术后受者血清钙逐步升高,高钙血症的发生率在术后3个月时达到最高值42.6%,随后逐步下降,至术后12个月时为39.1%。患者所有随访时间点的血清钙均3.0 mmol/L。多因素线性回归分析显示术前高iPTH、术后6个月时低磷血症和高碱性磷酸酶是术后6个月时高钙血症的危险因素,术前透析时间长和术前高iPTH是术后12个月时发生高钙血症的危险因素。结论:肾移植术后1年内30%~40%的受者可出现高钙血症。术前高iPTH是术后6个月和12个月时高钙血症的危险因素。监控术前iPTH有助于术后高钙血症的预防和治疗。
[Abstract]:Objective: to investigate the incidence and risk factors of hypercalcemia in one year after renal transplantation, and to observe the evolution of serum calcium. Methods: from November 2013 to March 2015, 115 patients underwent renal transplantation in the Department of Kidney of Nanjing military region General Hospital of Nanjing military region. Serum calcium levels were measured at 1 month, 3 months, 6 months and 12 months after renal transplantation, respectively. Total parathyroid hormone (iPTH) and other mineral and bone metabolism indicators. Results: the level of serum calcium increased gradually after renal transplantation, and the incidence of hypercalcinemia reached the highest value of 42.6 at 3 months after transplantation, then decreased gradually, and was 39.1 at 12 months after transplantation. Serum calcium levels at all follow-up time points were 3.0 mmol/L. Multivariate linear regression analysis showed that hypophosphatemia and hyperalkaline phosphatase were the risk factors of hypercalcemia at 6 months postoperatively with high iPTH,. Long duration of preoperative dialysis and preoperative high iPTH were risk factors of hypercalcemia 12 months after operation. Conclusion: 30% of recipients have hypercalcemia within 1 year after renal transplantation. Preoperative high iPTH was a risk factor for hypercalcemia at 6 and 12 months postoperatively. Monitoring preoperative iPTH is helpful for the prevention and treatment of postoperative hypercalcemia.
【作者单位】：第二军医大学金陵医院(南京军区南京总医院)肾脏科国家肾脏疾病临床医学研究中心全军肾脏病研究所;
【基金】：国家科技支撑计划课题(2015BAI12B02,2015BAI12B05) 江苏省科技计划项目(BE2016747)
【分类号】：R699.2

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