慢性肾衰继发性甲旁亢iPTH水平变化的临床意义及罗钙全疗效观察  

The Climical Cheange of iPTH of Chronic Renal Pailure Inroduced Hyperparathy Roidism and the Effecos of Rocaltrol

作　　者：张拔山[1] 林宏初[2] 曾龙宏[1] 赖福娣[1] 

机构地区：[1]东莞市人民医院检验科,广东东莞523000 [2]东莞市人民医院肾内科,广东东莞523000

出　　处：《国际医药卫生导报》2004年第18期38-40,共3页International Medicine and Health Guidance News

摘　　要：目的探讨慢性肾功能衰竭(CRF)并发继发性甲状旁腺机能亢进(SHPT)血中全段甲状旁腺激素(iPTH)水平变化的临床意义及小剂量罗钙全对慢性肾衰继发甲旁亢早期的疗效观察。方法分别采用免疫放射法、苦味酸法、偶氮胂Ⅲ法、直接紫外法测定60例健康体检者和94例CRF患者血iPTH、Cr、Ca、P含量;取iPTH含量87.5～295ng/L的SHPT病人随机分为观察组和治疗组各23例,治疗组每天口服罗钙全0.25ug。结果血iPTH水平随肾功能损害的加重而逐渐升高,与Cr成正相关,P亦逐渐升高,Ca则逐渐降低;治疗组服药3个月后,血iPTH显著降低(P<0.05),Ca明显升高(P<0.05),P无显著性差异(P>0.05),观察组血iPTH显著升高(P<0.05)。结论iPTH可作为早期诊断CRF继发性甲旁亢的敏感指标且其水平与肾功能损害程度一致;口服小剂量罗钙全治疗早期SHPT的疗效与iPTH水平有关。Objectives To investigate the change of intact parathyroid hormone(iPTH) of chronicrenal failuer(CRF) introduced secondary hyperparathyroidism(SHPT) and the early effects of little doseof Rocaltrol.Methods Blood iPTH,Cr,Ca,P were detected with the methods of IRMA,Jaffe,Arsenazo III,Direct UV on 60 healthy people and 94 cases of CRF respectiveiy.SHPT patients whose iPTH were 87.5～295ng/L were seperated randomly into Rocaltrol groupe and control groupe.Patients of the Rocaltrolgroupe wewe given 0.25ug Rocaltrol but those of the control groupe were not given. Result Blood iPTHaccelerated as renal failure aggravated positively correlating with Cr and so did P.But Ca++ dedined.After 3 months of Rocaltrol treatment,iPTH declined(P<0.05),Ca++ accelerated(P<0.05),P did not changeobviously. Blood iPTH of the control groupe accended(P<0.05). onclusion iPTH can be set as an index ofearly dignosis of CRF introduced SHPT and it is correlated with the rend compact degree the effectivenessof Rocaltrol for early SHPT is correlated with the iPTH level.

关 键 词：慢性肾衰 继发性甲旁亢 全段甲状旁腺激素 早期诊断 罗钙全 

分 类 号：R692.5[医药卫生—泌尿科学]