基于PSM法分析CKD5期维持性血液透析患者并发继发性甲状旁腺功能亢进的影响因素
Analysis of the influencing factors of secondary hyperparathyroidism in patients with stage 5 chronic kidney disease maintenance hemodialysis based on propensity score matching method
刘菲 1李小玉1
作者信息
- 1. 信阳市中心医院肾病内科,河南信阳 464000
- 折叠
摘要
目的 采用倾向性评分匹配(PSM)法探讨慢性肾脏病(CKD)5 期维持性血液透析患者并发继发性甲状旁腺功能亢进(SHPT)的影响因素.方法 回顾性分析 2020 年 1 月～2023 年 5 月我院 100 例CKD 5 期维持性血液透析患者的临床资料,按照有无并发SHPT分为并发SHPT组(n=39)与未并发SHPT组(n=61).采用PSM法对并发SHPT组、未并发SHPT组进行匹配,共匹配 37 对.采用Logistic回归法分析CKD 5 期维持性血液透析患者并发SHPT的影响因素.结果 匹配后,并发SHPT组合并糖尿病、原发糖尿病肾病及营养不良占比升高(P<0.05),高敏C反应蛋白(hs-CRP)、血磷及碱性磷酸酶(ALP)水平升高(P<0.05),血液透析联合血液滤过占比降低(P<0.05),维持血液透析时间延长(P<0.05).Logistic回归分析显示,原发糖尿病肾病(OR=1.861,95%CI:1.448～2.391)、hs-CRP(OR=1.754,95%CI:1.320～2.331)、血磷(OR=1.935,95%CI:1.373～2.726)、ALP(OR=1.645,95%CI:1.260～2.148)、营养不良(OR=1.844,95%CI:1.276～2.666)及维持性血液透析时间(OR=1.883,95%CI:1.366～2.597)是CKD 5 期维持性血液透析患者并发SHPT的危险因素(P<0.05),血液透析联合血液滤过(OR=0.544,95%CI:0.424～0.700)是CKD 5 期维持性血液透析患者并发SHPT的保护因素(P<0.05).结论 经PSM法发现,CKD 5期维持性血液透析患者并发SHPT的危险因素包括原发糖尿病肾病、hs-CRP、血磷、ALP及营养不良,保护因素为血液透析联合血液滤过.
Abstract
Objective To explore the influencing factors of secondary hyperparathyroidism(SHPT)in patients with stage 5 chronic kidney disease(CKD)maintenance hemodialysis based on propensity score matching(PSM)method.Methods Clinical data of 100 patients with stage 5 CKD and maintenance hemodialysis in our hospital from Jan 2020 to May 2023 were retrospectively analyzed.The patients were divided into two groups based on the presence or absence concurrent SHPT:the SHPT group(n=39)and the non-SHPT group(n=61).The PSM method was used to match the SHPT group and the non-SHPT group,and a total of 37 pairs were matched.Logistic regression method was used to analyze the influencing factors of SHPT in stage 5 CKD maintenance hemodialysis patients.Results After matching,compared with the non-SHPT group,the SHPT group had a higher proportion of diabetes,primary diabetic nephropathy,and malnutrition(P<0.05),with increased levels of hs-CRP,serum phosphorus,and ALP(P<0.05).The proportion of hemodialysis combined with hemofiltration decreased(P<0.05),and the duration of maintenance hemodialysis was prolonged(P<0.05).Primary diabetic nephropathy(OR=1.861,95%CI:1.448～2.391),hs-CRP(OR=1.754,95%CI:1.320～2.331),blood phosphorus(OR=1.935,95%CI:1.373～2.726),ALP(OR=1.645,95%CI:1.260～2.148),malnutrition(OR=1.844,95%CI:1.276～2.666)and maintenance hemodialysis time(OR=1.883,95%CI:1.366～2.597)were the risk factors for SHPT in stage 5 CKD maintenance hemodialysis patients(P<0.05),hemodialysis combined with hemofiltration(OR=0.544,95%CI:0.424～0.700)were the protective factor for SHPT in stage 5 CKD maintenance hemodialysis patients(P<0.05).Conclusion According to the PSM method,the risk factors of SHPT in stage 5 CKD maintenance hemodialysis patients include primary diabetic nephropathy,hs-CRP,blood phosphorus,ALP,malnutrition and maintenance hemodialysis time.The protective factor is hemodialysis combined with hemofiltration.
关键词
慢性肾脏病/5期/维持性血液透析/甲状旁腺功能亢进症/倾向性评分匹配Key words
Chronic kidney disease/Stage 5/Maintenance hemodialysis/Secondary hyperparathyroidism/Propensity score matching引用本文复制引用
出版年
2024
NETL
NSTL
万方数据