腹膜透析患者发生难治性甲状旁腺功能亢进的相关因素分析  

Risk factor analysis of refractory secondary hyperparathyroidism in patients undergoing continuous ambulatory peritoneal dialysis

作　　者：徐志宏[1] 董敏 李艳博[3] 邢淑宁[1] 张凌[1] 金承刚[4] 李文歌[1] XU Zhi-hong;DONG Min;LI Yan-bo(Department of Nephrology,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院肾病科,北京100029 [2]山东省平原县人民医院肾内科,山东平原253100 [3]北京中医药大学管理学院,北京100029 [4]北京师范大学社会发展与公共政策学院,北京100875

出　　处：《中日友好医院学报》2018年第6期327-329,333,共4页Journal of China-Japan Friendship Hospital

摘　　要：目的:探讨引起腹膜透析患者的难治性甲状旁腺功能亢进(SHPT)的相关因素。方法:分析2015年11月～2018年5月于我院行甲状旁腺切除术的51例腹膜透析患者临床资料,并与我院同期50例甲状旁腺激素<300pg/ml的腹膜透析患者进行比较,对发生难治性SHPT的相关因素:血钙、血磷、血白蛋白及透析龄、透析液种类、合并糖尿病情况以及开始检测iPTH的时间等进行逻辑回归分析。结果:2组血钙、血磷、透析龄、血白蛋白、开始检测iPTH的时间均存在显著性差异(P<0.01,P<0.05)。行手术的难治性甲状旁腺功能亢进组患者开始检测iPTH的时间,明显晚于甲状旁腺激素在300pg/ml以下的腹膜透析患者(P<0.01)。回归分析显示,透析龄长、高血磷、开始检测iPTH时间等均是腹膜透析患者发生难治性SHPT的风险因素。结论:腹膜透析患者高透析龄、高血磷、开始检测iPTH晚等是其发展为难治性SHPT的风险因素。Objective:To investigate the risk factors of refractory secondary hyperparathyroidism (SHPT)in patients with continuous ambulatory peritoneal dialysis (CAPD).Methods:The study enrolled 101patients with CAPD,fifty-one cases of whom were diagnosed as refractory SHPT and underwent parathyroidectomy in recent two and a half years in our hospital.The other 50cases were CAPD patients in our hospital,whose intact parathyroid hormone (iPTH)were well controlled (lower than 300pg/ml).Logistic regression analysis was performed on the clinical data of two groups to analyze the influence factors of refractory SHPT in CAPD patients.Results :There were significant differences in the levels of serum calcium,phosphorus,dialysis vintage and serum albumin between the two groups (P<0.01,P<0.05).The use ratio of low-calcium peritoneal dialysis solution,the time to start iPTH testing were significantly different between the two groups(P<0.01).Logistic regression analysis showed that the dialysis vintage,blood phosphate and the time of start iPTH testing were influence factors of refractory SHPT in CAPD patients.Conclusion:High dialysis vintage,high blood phosphate level and late detection of iPTH may be the risk factors for developing refractory SHPT in CAPD patients.

关 键 词：腹膜透析 难治性继发性甲状旁腺功能亢进 

分 类 号：R692.5[医药卫生—泌尿科学]