经皮乙醇注射治疗血液透析继发甲状旁腺机能亢进症远期预后研究  

Long-term prognosis of secondary hyperparathyroidism in hemodialysis patients after percutaneous ethanol injection therapy

作　　者：罗洋[1] 张凌[1] 卞维静[1] 刘亚绵[2] 李程[1] 李文歌[1] 谌贻璞[1] 

机构地区：[1]中日友好医院肾病中心,北京100029 [2]中日友好医院超声科,北京100029

出　　处：《中日友好医院学报》2007年第6期333-335,348,共4页Journal of China-Japan Friendship Hospital

摘　　要：目的:观察经皮乙醇注射治疗(PEIT)对血液透析患者继发性甲状旁腺机能亢进症(SHPT)3年内的远期预后。方法:对26例慢性肾衰竭维持性血液透析合并SHPT患者,在B超引导下对直径>1.0cm的甲状旁腺行PEIT,对预后进行随访。结果:26例患者中共15例完成3年的随访,血清全段甲状旁腺激素(iPTH)水平由715.9±432.3pg/ml降低至435.4±105.6pg/ml,血清碱性磷酸酶(ALP)从302.9±214.4IU/L降低至164.4±74.2IU/L,血磷从5.9±3.8mg/dl降低至4.9±3.0mg/dl(P<0.05)。PEIT后1年时6例(40%)、PEIT后3年时4例(27%)患者血清iPTH维持在<600pg/ml。结论:在血液透析SHPT患者中应用PEIT是一个有效手段,SHPT复发的患者可能需要甲状旁腺切除术,部分患者可以维持长期甲状旁腺功能稳定。Objective：To observe the long-term prognosis of secondary hyperparathyroidism（SHPT）in hemodialysis patients after percutaneous ethanol injection therapy（PEIT）.Methods：Fifteen out of 26 cases of end stage renal diseased patients submitted to hemodialysis with SHPT were selected based on the criteria for PEIT.Ultrasound guided injection of ethanol in 36 enlarged （〉1cm in diameter） and ample blood supply parathyroid glands.A 3 years of follow up was executed by detecting several biochemical parameters and ultrasonic examination among those patients.Results：All patients showed a decline in the serum intact parathyroid hormone （iPTH） concentration, on average from 715.9±432.3 to 435.4±105.6 pg/ml （P〈0.05） after 3 years.The mean serum alkaline phosphatase（ALP）concentration also decreased significantly from 302.9±214.4 to 164.4±74.2IU/L after 3 years.Serum phosphate was also reduced significantly from 5.9±3.8mg/dl to 4.9±3.0mg/dl （P〈0.05）.Six cases （40%）serum iPTH were sustained less than 600pg/ml after 1 year of PEIT,4 cases （27%）serum iPTH were sustained less than 600pg/ml after 3 year of PEIT.Conclusion：It seems that PElT is an effective method to treat SHPT, some of them are able to maintain long-term parathyroid function after PEIT, however, some of them still need to have parathyroidectomy operation when relapse.

关 键 词：血液透析 继发性甲状旁腺机能亢进症 经皮乙醇注射治疗 

分 类 号：R692.5[医药卫生—泌尿科学]