慢性肾病患儿血清1，25-二羟维生素D3水平与并发症及肾功能关系

摘要

Objective To study the relationships among serum 1,25- dihydroxy Vitamin D3 content, the complications and renal function of children with chronic kidney disease. Methods 120 cases of children patients with chronic kidney disease from June 2012 to June 2014 in our hospital were selected as the observation group . Another 60 cases of healthy children were selected as the control group. serum calcium,phosphorus,creatinine clearance rate,serum creatinine and serum1,25- dihydroxy Vitamin D3 level of two groups were compared,corresponding complication rates of different serum 1,25- dihydroxy vitamin D3 level of the observation group were compared ;According to urinary albumin / creatinine ratio(ACR) and serum creatinine(CR)values,the observation group was divided into microalbuminuria group,a large number of proteinuria group and renal insufficiency group,serum 1,25- dihydroxy Vitamin D3 level,Ca、P level of three groups were compared .Results Ca,Ccr and serum 1,25-dihydroxy Vitamin D3 content of the observation group was obviously lower than those of the control group level,P and Cr were significantly higher than the level of control group;With the decreasing of 1,25- dihydroxy Vitamin D3 level,incidence of complications of the patients with chronic kidney disease increased . Serum 1,25- dihydroxy Vitamin D3 level had a negatively correlated relationship with the incidence of complications of patients with chronic kidney disease(r=-0.563,P<0.05). With the kidney function damage degree increasing,serum P、Cr levels increased,serum Ca、Ccr、1,25- dihydroxy Vitamin D3 levels gradually decreased,serum 1,25- dihydroxy Vitamin D3 level had a negative correlation with renal function of patients with chronic kidney disease(r=-0.389,P<0.05). Conclusion 1,25- dihydroxy Vitamin D3 of serum participate in a series of biochemical reaction of chronic kidney disease,by detecting their serum levels, the progession of this disease can be monitored and assessed, also it will be helpful for the prevention and treatment.%目的：探讨慢性肾病患儿血清1，25-二羟维生素D3含量与其并发症及肾功能的相关性。方法慢性肾病患儿120例为观察组，健康儿童60例为对照组，比较两组患儿血钙、血磷（P）、肌酐清除率（Ccr）、血肌酐（Cr）及血清1，25-二羟维生素D3水平。比较观察组不同血清1，25-二羟维生素D3水平对应的并发症发生率；根据尿微量白蛋白/肌酐比值（ACR）及Cr值将观察组分为微量蛋白尿组，大量蛋白尿组及肾功能不全组，比较三组血清1，25-二羟维生素D3水平、Ca、P水平。结果观察组的Ca，Ccr及血清1，25-二羟维生素D3含量明显低于对照组水平，P及Cr含量明显高于对照组水平。随着血清1，25-二羟维生素D3水平的降低，慢性肾病患儿并发症发生率升高，血清1，25-二羟维生素D3水平与慢性肾病患儿并发症发生率呈负相关（r=-0.563，P<0.05）。随着肾功能损害严重程度的增加，血清P、Cr水平增加升高，血清Ca、Ccr、1，25-二羟维生素D3水平逐渐降低，血清1，25-二羟维生素D3水平与慢性肾病患儿肾功能呈负相关（r=-0.389，P<0.05）。结论血清中的1，25-二羟维生素D3参与慢性肾病的一系列生化反应，对其进行监测能够对此病症的发展程度进行评估。对其水平进行研究，能够有效对此病症进行预防和诊治。值得临床推荐。