Analysis Of Pulmonary Function And Its Influencing Factors In Maintenance Hemodialysis Patients With Secondary Hyperparathyroidism

Objective To explore the characteristics of pulmonary function and its influencing factors in patients with secondary hyperparathyroidism in maintenance hemodialysis,and to provide a scientific basis for clinical prevention and treatment.Methods 254 hemodialysis patients with secondary hyperparathyroidism were divided into group A i PTH>800 pg/ml(n=229)and group B 300≦i PTH<800 pg/ml(n=25)according to the different i PTH levels.Hemoglobin(Hb),albumin(Alb),urea nitrogen(BUN),creatinine(Scr),serum calcium,phosphorus,alkaline phosphatase(ALP),intact parathyroid hormone(i PTH),and C-reactive protein(CRP)were determined.Simultaneous determinnaton: Pulmonary volume: include vital capacity(VC),total lung capacity(TLC),residual volume(RV),the ratio of residual volume and total lung capacity(RV/TLC);Ventilation function: include forced vital capacity(FVC),maximum expiratory flow(PEF),forced expiratory volume in 1s(FEV1);Small airway function: include expiratory flow volume of forced vital capacity at 25% and 50%;Dispersion function:diffusing capacity of in the lung(DLCO).The difference of lung function between the two groups was compared and the influencing factors were analyzed.Results Compared with group B,serum calcium,phosphorus and ALP were significantly increased in group A.VC,FVC,FEV1,PEF,V25,V50 and DLCO of the group A were significantly lower than those in the B group.Correlation analysis showed that the lung ventilation function of the FEV1 and PEF was negatively correlated with dialysis age.The correlation between pulmonary volume,ventilation function,small airway function,diffusion function and i PTH,there was a positive correlation between RV/TLC and i PTH,the rest were negatively related with i PTH;DLCO was positively correlated with Hb;there was negative correlated between VC,FVC,FEV1 and CRP;a positive correlation between FEV1 and Hb.Conclusions The pulmonary function characteristics of patients with secondary hyperparathyroidism in maintenance hemodialysis were characterized by the decrease of ventilation function,diffusion function,small airway dysfunction,the more impaired lung function with the higher i PTH level.The factors affecting the pulmonary function of patients with secondary hyperparathyroidism with maintenance hemodialysis were i PTH,CRP,dialysis age,Alb and Hb,some of the pulmonary function indexes were negatively correlated with i PTH,CRP and dialysis age,and were positively related to the level of Alb and Hb.Multiple linear regression analysis showed that i PTH,Hb and CRP were the risk factors affecting the pulmonary function of patients with secondary hyperparathyroidism.