甲状旁腺切除术对血液透析的肾功能衰竭患者甲状旁腺激素改变的分析  

Analysis of parathyroid hormone change in hemodialysis patients with renal failure treated by parathyroidectomy

作　　者：李卫东 张曼丽 张凌[2] 姚力[2] 杜书同 

机构地区：[1]河北省沧州市人民医院,河北沧州061000 [2]中日友好医院,北京100029

出　　处：《热带医学杂志》2015年第5期649-651,共3页Journal of Tropical Medicine

摘　　要：目的探讨甲状旁腺切除术对血液透析患者生活质量的影响。方法选取河北省沧州市人民医院2013年1月至2014年1月所收治的78例维持性血液透析伴有继发性甲状旁腺功能亢进症(SHPT)患者的临床资料,根据是否实行甲状旁腺切除术(PTX)分为PTX组38例,非PTX组40例,观察治疗前、治疗后血钙、血磷、血清全段甲状旁腺激素(i PTH)、碱性磷酸酶(ALP)并进行比较;应用简明健康测量量表(SF-36)计算得分并比较。结果术后PTX组其钙、磷、i PTH、ALP分别与同组术前相比,与非PTX组药物治疗后相比较各指标差异有统计学意义(P<0.05);SF-36评分术后3个月PTX组与非PTX组比较在8个维度均有提高(P<0.05)。结论甲状旁腺切除术改善血液透析患者预后的治疗效果确切,并且安全性高,可以在临床上推广使用。Objective To investigate the therapeutic impact of parathyroidectomy on the life quality of hemodialysis patients. Methods The clinical data of 78 cases of hemodialysis with secondary hyperparathyroidism（SHPT） enrolled in our hospital from January 2013 to January 2014 were analyzed. All patients were assigned into the PTX group or the nonPTX group depending on whether received parathyroidectomy. The PTX group contained 38 cases and the non-PTX group contained 40 cases. The serum calcium, phosphorus, serum intact parathyroid hormone（i PTH） and alkaline phosphatase（ALP） levels were examined and compared before and after treatment. The concise health measurement scale（SF-36）was employed to compare therapeutic effects between the two groups. Results Compared to the levels before treatment and of the non-PTX group, the differences in serum calcium, serum phosphorus, i PTH and ALP levels of the PTX group were statistically significant（P〈0.05）. After surgery the SF-36 scores of the PTX group were increased comparing the non-PTX group in eight dimensions（P〈0.05）. Conclusion The therapeutic effects of parathyroidectomy on improving the prognosis of patients receiving hemodialysis are promising and reliable. The surgery is worthy to be promoted in clinical application.

关 键 词：甲状旁腺切除术 继发性甲状旁腺功能亢进症 血液透析 肾功能衰竭 甲状旁腺激素 

分 类 号：R653[医药卫生—外科学]