目的:探讨维持性血液透析(MHD)合并难治性继发性甲状旁腺功能亢进(r SHPT)患者腹主动脉钙化(AAC)的相关因素。方法:选取2014年5月至2016年1月间于中日友好医院就诊拟行甲状旁腺切除术的r SHPT患者,记录患者一般情况,血清全段甲状旁腺激素(i PTH)、血清钙(Ca)、血清磷(P)及骨转化标志物等实验室指标,测量骨密度(BMD),根据AAC评分分为无钙化、轻度钙化、中重度钙化三组,比较三组之间的差异。结果:82例r SHPT患者纳入研究,年龄50.99±12.98岁,透析龄88.42±50.15月,男性40例占48.8%。AAC发生率为63.4%,其中腰椎L1~L4对应的四段血管壁均受累20例(24.4%)。男性AAC积分更高(P=0.016)。与无钙化组相比,发生钙化的两组年龄更大(P<0.001),透析龄更长(P<0.05);轻度及中重度钙化组的I型胶原羧基端肽(CTX)明显低于无钙化组(P<0.05)。多重线性回归分析发现:AAC与年龄(r=0.042,P<0.001)、血清磷(r=0.438,P=0.045)呈正相关,与CTX(r=-0.100,P=0.035)呈负相关。结论:MHD合并r SHPT患者AAC发生率高,高龄、男性、高血磷及CTX低是血管钙化的易感因素。 Objective: To investigate the related factors of abdominal aortic calcification (AAC) in patients with maintenance hemodialysis (MHD) and refractory secondary hyperparathyroidism (r SHPT). Methods: The patients with r SHPT undergoing parathyroidectomy at Sino-Japanese Friendship Hospital from May 2014 to January 2016 were enrolled. The general conditions, serum total parathyroid hormone (i PTH), serum calcium (Ca), serum phosphorus (P), markers of bone turnover and other laboratory indicators, bone mineral density (BMD) was measured, divided into three groups according to AAC score: no calcification, mild calcification, moderate calcification; difference. RESULTS: Eighty-two patients with r-SHPT were enrolled in the study, aged 50.99 ± 12.98 years, with a dialysis age of 88.42 ± 50.15 months and 40 males accounting for 48.8%. The incidence of AAC was 63.4%, of which 20 cases (24.4%) were involved in the four vessel segments corresponding to L1 ~ L4 in lumbar spine. Male AAC score higher (P = 0.016). Compared with no calcification group, calcification in both groups was older (P <0.001) and dialysis age was longer (P <0.05). Type I collagen carboxyterminal peptide (CTX) in mild and moderate calcification group was significantly lower No calcification group (P <0.05). Multiple linear regression analysis showed that AAC was positively correlated with age (r = 0.042, P <0.001), serum phosphorus (r = 0.438, P = 0.045) and negatively correlated with CTX (r = -0.100, P = 0.035) Conclusions: The incidence of AAC in MHD patients with r SHPT is high. Aging, males, hyperphosphatemia and low CTX are the predisposing factors of vascular calcification.