维持性血液透析患者甲状旁腺激素水平的临床分析  

Study of the serum levels of parathyroid hormone in maintenance hemodialysis patients

作　　者：田茹[1] 孙尉明[1] 郭一丹[1] 

机构地区：[1]北京世纪坛医院肾内科,100038

出　　处：《国际移植与血液净化杂志》2010年第3期33-37,共5页International Journal of Transplantation and Hemopurification

摘　　要：目的探讨慢性。肾功能衰竭维持性血液透析患者不同血浆全段甲状旁腺激素水平影响因素的差异。方法在2006年9月至2009年8月期间于我院门诊维持性血液透析慢性肾功能衰竭患者中随机选择血浆全段甲状旁腺激素〉1000ug／L患者20例（高甲状旁腺激素组）；血浆全段甲状旁腺激素〈150ug/L的患者20例（低甲状旁腺激素组）。对两组患者的临床资料进行回顾性分析。结果两组患者年龄、病死率、原发病、血肌酐、尿素氮、血浆白蛋白、血磷及钙磷乘积方面比较差异有统计学意义（P〈0．05）；两组患者性别、血红蛋白、胆固醇、甘油三酯、血钙及二氧化碳结合力方面比较差异无统计学意义（P〉0．05）。结论在慢性肾功能衰竭维持性血液透析中高龄及糖尿病肾病患者低甲状旁腺激素水平的发生率明显增高；低甲状旁腺激素水平的患者病死率明显增高；高甲状旁腺激素水平患者的血肌酐、血磷及钙磷乘积水平明显高于低甲状旁腺激素水平患者，营养状况也优于后者。Objective To investigate the different factors in maintenance hemodialysis patients with different serum levels of intact parathyroid hormone （iPTH）. Methods To choose 20 patients with higher serum iPTH levels（ iPTH 〉 1000 ug/L）and other 20 patients with lower serum iPTH levels（ iPTH 〈 150 ug/L）among the chronic renal failure（CRF） patients who received hemodialysis in Beijing Shijitan Hospital from September 2006 to August 2009. The two groups were analyzed retrospectively. Results There were significant differences in age, disease death rate, primary diseases and the levels of serum creatinine（Ser）, blood urea nitrogen （Bun）, plasma-albumin （Alb）, phosphorous （P） and product Ca × P between the two groups However, there were no significant differences in sex and the levels of serum calcium （Ca）, hemoglobin（Hb）, cholesterol（ CHOL）, triglyceride（TRIG） and carbon dioxide combining power（CO2CP） between them. Conclusions Among the CRF patients which received hemodialysis： The incidence of the lower serum iPTH levels among the elderly and CRF patients due to diabetic nephrosis is obviously high; The death rate of group 2 is obviously higher than that of group 1 ; The levels of Ser, P and product Ca × P of group 1 are obviously higher than that of group 2 and nutritional status of the former is better than that of the latter.

关 键 词：血液透析 甲状旁腺激素 血肌酐 血磷 血浆白蛋白 病死率 原发病 

分 类 号：R692.5[医药卫生—泌尿科学]