糖尿病肾病与非糖尿病肾病维持性血液透析患者血钙、血磷及甲状旁腺激素水平的分析  

Analysis of the Serum Calcium, Phosphorus and Intact Parathyroid Hormone of Diabtic Nephropgthy and Non-diabtic Nephropgthy Patients with Maintenance Hemodialysis

作　　者：张晓玲[1] 白久旭[1] 韩敬明[1] 王东辉[1] 崔汉民[1] 曹宁[1] 

机构地区：[1]沈阳军区总医院血液净化科,辽宁沈阳110015

出　　处：《现代生物医学进展》2013年第30期5896-5899,5928,共5页Progress in Modern Biomedicine

基　　金：辽宁省科技攻关课题(2010225036)

摘　　要：目的:探讨糖尿病肾病(diabtic nephropgthy,DN)与非糖尿病肾病(non-DN)维持性血液透析患者(maintenance hemodialysis,MHD)血钙、血磷、甲状旁腺激素(intact parathyroid hormone,iPTH)水平的差异;分析其血钙、血磷、iPTH和糖化血红蛋白(glycosylated hemoglobin,HbA1c)水平的相关性。方法:选择沈阳军区总医院血液透析中心收治的148例MHD患者,分为糖尿病组(58例)和非糖尿病组(90例),比较两组间血钙、血磷、甲状旁腺激素水平的差异,并分析其血钙、血磷、iPTH、HbA1c水平的相关性。结果:糖尿病组iPTH、血磷水平均明显低于非糖尿病组(P<0.05),两组血钙水平比较无明显差异。在非DN组中,iPTH与血钙水平呈显著负相关(r=-0.320,P=0.036),iPTH与血磷水平呈明显正相关(r=0.426,P=0.005)。在DN组中,iPTH与血钙、血磷无显著相关性,而iPTH与HbA1C水平呈显著负相关(r=-0.732,P=0.007)。结论:糖尿病肾病血液透析患者的iPTH水平和血磷水平明显低于非糖尿病肾病血液透析患者,HbA1c可能抑制iPTH的分泌。Objective： To compare the differences of serum calcium, phosphorus, intact parathyroid hormone（iPTH） levels and their changes in the hemodialysis course between diabtic nephropgthy and non-diabtic nephropgthy patients with maintenance hemodialysis, the correlation between serum levels of calcium（Ca）, phosphorus（P）, intact parathyroid hormone（iPTH） in both groups of patients were analyzed. Methods： A total of 148 patients with maintenance hemodialysis were surveyed in this study. Patients were divided into diabetic nephropathy（DN, n=58） and non- diabetic nephropathy group（non-DN, n=90）. Clinical data were compared between the groups, correlations were analyzed between Ca, P, HbA1c and iPTH levels. Results： Serum iPTH and phosphorus were significantly lower in DN group than in non-DN group（P0.05）. There was no significant difference of calcium between the DN and the non-DN patients. A negative correlation beteen iPTH and Ca（r=-0.320, P=0.036） and a positive correlation between iPTH and P（r=0.426, P =0.005） were found in the non-DN group. No significant correlation between iPTH, Ca and P was observed in the DN group. A negative correlation between Serum iPTH and HbA1c（r=-0.732, P=0.007） was showed in the DN group. Conclusion： Serum iPTH level and phosphorus were lower in diabtic nephropgthy haemodialysis patients than in non-diabtic nephropgthy patients, which indicate that high serum concentration of glucose suppresses iPTH secretion.

关 键 词：糖尿病肾病 维持性血液透析 糖化血红蛋白 甲状旁腺激素 

分 类 号：R587.2[医药卫生—内分泌]