甲状旁腺素在草酸钙结石防治中的临床研究  

作　　者：吴晓鸣[1] 何屹[2] 曹益方 张高岳 陈昊[2] 吴建惠[2] 

机构地区：[1]浙江中医药大学第二临床学院,310053 [2]浙江省嘉兴市第一医院,314000

出　　处：《浙江临床医学》2017年第5期827-828,共2页Zhejiang Clinical Medical Journal

摘　　要：目的探讨草酸钙结石患者的甲状旁腺素、血钙、24h尿钙浓度与结石复发率的相关性，以及维生素D3在降低甲状旁腺素及结石复发的作用，为泌尿系结石的防治提供新的依据。方法草酸钙结石患者80例，根据甲状旁腺素是否升高，分为甲状旁腺素正常组与甲状旁腺素升高组，甲状旁腺素升高组分为服用维生素D3组和空白对照组。1年内检测三组患者血钙、24h尿钙、血甲状旁腺素，B超检查结石复发率。结果随访1年，空白对照组血钙、24h尿钙、结石复发率均高于甲状旁腺素正常组和维生素D3组（P〈0．05）；甲状旁腺素正常组与维生素D3组血钙，24h尿钙，结石复发率比较差异无统计学意义。结论甲状旁腺素升高患者结石易复发，维生素D3能降低患者甲状旁腺素水平，减少结石复发。Objective To investigate the correlation of the levels of serum parathyroid hormone （ PTH ） , serum calcium, 24 hours urine calcium with the calculi reoccurrence rate, and the effects of vitamin D3 in decreasing PTH and calculi reoccurrence rate in urolithiasis patients in order to provide novel treatments for urolithiasis. Methods Patients with calcium oxalate calculi were divided into higher PTH group and normal PTH group according to their serum PTH levels. The higher PTH group was further divided into vitamin D3 treated group and blank control treated group. Serum calcium, serum PTH and 24 hours urine calcium levels were monitored in all the patients for a year. In the meantime, B-mode ultrasound was used to monitor the calculi reoccurrence rate. Results The data from 1-year follow-up study suggested that levels of serum calcium, 24 hours urine calcium and calculi reoccurrence rate of the blank control group were significantly higher than those of the normal PTH group and the vitamin D3 group. Meanwhile, no significance was found between the control group and the vitamin D3 group. Conclusions The patients with elevated PTH level have higher risk of calculi reoccurrence. However, vitamin D3 treatment is effective in lowering serum PTH level and reducing the calculi reoccurrence rate.

关 键 词：甲状旁腺素 草酸钙结石 结石复发率 

分 类 号：R692.5[医药卫生—泌尿科学]