不同甲状旁腺激素水平的慢性肾脏病5期患者贫血指标比较及相关性分析  

Comparison and Correlation Analysis of Anemia Parameters in Stage 5 Chronic Kidney Disease Patients with Different Parathyroid Hormone Levels

作　　者：王芹[1] 魏从丽 张百中 徐敏[1] 韩洪波[1] 刘金凤[1] 

机构地区：[1]沭阳县人民医院肾内科,江苏沭阳223600

出　　处：《医学综述》2017年第7期1454-1456,F0003,共4页Medical Recapitulate

摘　　要：目的分析不同甲状旁腺激素(PTH)水平的慢性肾脏病(CKD)5期患者贫血指标及相关性。方法选取2013年10月至2016年4月在沭阳县人民医院住院治疗的CKD 5期(非透析)患者186例,依照CKD 5期PTH的正常参考范围(150.0~600.0 ng/L)将患者分为3组:Ⅰ组(PTH≤150.0 ng/L)(n=23)、Ⅱ组(PTH 150.0~600.0 ng/L)(n=126)、Ⅲ组(PTH>600.0 ng/L)(n=37)。比较3组患者贫血指标的差异,并分析其与PTH水平的相关性。结果 3组患者的红细胞计数(RBC)分别为:Ⅰ组(2.97±0.61)×10^(12)/L、Ⅱ组(2.96±0.59)×10^(12)/L和Ⅲ组(2.62±0.84)×10^(12)/L;血红蛋白浓度(Hb)分别为:Ⅰ组为(90.16±19.95)g/L、Ⅱ组为(86.26±17.43)g/L和Ⅲ组为(77.28±24.16)g/L;血细胞比容(Hct)分别为:Ⅰ组(27.60±5.97)%、Ⅱ组(26.60±5.07)%和Ⅲ组(23.72±7.46)%。极高PTH组(Ⅲ组)的RBC、Hb和Hct均明显低于Ⅰ组、Ⅱ组(P<0.05);而Ⅰ和Ⅱ组两组间比较,RBC、Hb、Hct的差异均无统计学意义(P>0.05)。相关性分析结果显示:PTH与RBC、Hb、Hct均呈负相关(r=-0.247、-0.243、-0.240,P<0.001)。结论极高的PTH水平伴有较低的RBC、Hb、Hct水平,且3个贫血指标均与CKD患者体内的PTH水平呈负相关。Objective To observe the parameters of anemia comparison and correlation between different parathyroidhormone levels and these index of patients with chronic kidney disease （CKD） in stage 5. Methods Selected from October2013 to April 2016 186 patients with CKD 5 （non dialysis） treated in Shuyang People＇s Hospital were divided into threegroups according to the normal reference range of CKD 5 PTH （150.0-600.0 rig/L） ： group I （PTH 〈 150.0 ng/L） （n =23 ）, groupⅡ （ IYI＇H 150.0-600.0mg/L） （ n = 126） and group Ⅲ （ PTH 〉 600.0 ng/L） （ n = 57）. The differences of ane-mia parameters among the three groups were compared, and the relationship between these parameters and PTH was ana-lyzed. Results Red cell count（RBC） in the three groups were ： group I （2.97 ± 0.61 ） 10^12/L, group Ⅱ（ 2.96±0.59） x 10^12/L and group m （2.62 ±0.84） x 10^12/L;hemoglobin（Hb） concentrations were ：group I（90. 16 ± 19.95） g/L,group U （ 86.26 ± 17.43 ） g/L and group III （77.28 ± 24.16 ） g/L ; hematocrit （I-let） were ： group I （27.60 ± 5.97 ） %,group II （ 26.60 ± 5.07 ） % and group Ⅲ （23.72 ± 7.46 ） %. RBC, Hb and Het of high PTH group （ group HI ） were sig-nificantly lower than those in group I and group I] （ P 〈 0.05 ） ; group I and group II was compared, the difference ofRBC and Hb and Hct had no statistical significance （ P 〉 0.05 ）. Correlation analysis showed that PTH was negativelycorrelated with Hb, RBC, Hct（ r = - 0.247, - 0.243, - 0. 240 ,P 〈 0：001 ）. Conclusion Extremely high PTH levels wereassociated with lower RBC, Hb and Hct, and negatively correlated with the level of PTH in patients with CKD.

关 键 词：慢性肾脏病 甲状旁腺激素 血红蛋白 继发性甲状旁腺功能亢进症 肾性贫血 

分 类 号：R582.1[医药卫生—内分泌]