高血压肾病患者血清甲状旁腺激素与大动脉僵硬度关系研究  

Relationship between parathyroid hormone and arterial stiffness in patients with hypertensive nephropathy

作　　者：邬甦[1] 聂磊[2] 陈文龙[3] WU Su;NIE Lei;CHEN Wen-long(Department of General Practice,Jiangxi Provincal People’s Hospital,Nanchang 330000,China;First Department zone A Jiangxi Provincal People’s Hospital,Nanchang 330000,China;Emergency Department,Jiangxi Provincal People’s Hospital,Nanchang 330000,China)

机构地区：[1]江西省人民医院,江西南昌330000 [2]江西省人民医院一部A区,江西南昌330000 [3]江西省人民医院急诊科,江西南昌330000

出　　处：《吉林医学》2021年第5期1050-1053,共4页Jilin Medical Journal

摘　　要：目的:观察高血压肾病患者中甲状旁腺激素(PTH)与大动脉僵硬度关系。方法:按2010年高血压诊断与治疗指南与按KDOQI指南中根据肾小球滤过率(GFR)以及尿微量白蛋白肌酐比(ACR)将160例患者按慢性肾脏病危险分期,分为低危、中危、高危、极高危组,分别记录入选者的一般资料包括:性别、年龄、血压;使用全自动生化分析仪测定肾功能、血尿肌酐、尿微量白蛋白、钙磷水平;MDRD公式计算GFR采用动脉硬化自动测量仪测定臂踝脉搏波传导速度(baPWV);并使用放射免疫法测血清PTH。采用单因素方差分析及均数间多重比较方法分析四组间baPWV的差异。采用直线相关以及多元逐步线性回归分析baPWV的相关因素。结果:低危组、中危组、高危组、极高危组中的血压、GFR、ACR均有统计学差异(P<0.05)。四组baPWV值依次升高分别是[(1226±312)、(1455±275)、(1726±181)、(1926±282)cm/s;P<0.05];四组间PTH依次升高[(28.4±7.4)、(31.6±14.1)、(45.2±11.4)、(53.7±23.4)ng/ml;P<0.05];直线相关分析显示PTH与baPWV(r=0.252、P<0.01)呈正相关。多元逐步线性回归分析结果显示:在校正了血压、GFR、ACR、钙磷水平等因素后,年龄、PTH水平是baPWV独立相关因素(β=0.65、0.36,均P<0.01)。结论:在高血压肾病中,随着PTH升高,大动脉僵硬度升高。PTH水平与大动脉僵硬度相关。Objective To observe the relationship between parathyroid hormone and arterial stiffness in patients with hypertensive nephropathy.Method According to the risk stages of chronic kidney disease according to GFR and ACR in the diagnosis and treatment guidelines of hypertension in 2010 and KDOQI guidelines,160 patients were divided into low-risk,medium risk,high-risk and very high-risk groups.The baseline data of the selected patients were recorded respectively,including:gender,age,blood pressure;The renal function,creatinine,microalbumin,calcium and phosphorus were measured by using automatic biochemical analyzer.The CFR was calculated by MDRD formula.The arm ankle pulse wave velocity(baPWV)was measured by arteriosclerosis automatic measuring instrument.And the serum parathyroid hormone(PTH)was measured by radioimmunoassay.The difference of baPWV among the four groups was analyzed by single factor analysis of variance and multiple comparison between means.Linear correlation and multiple stepwise linear regression were used to analyze the related factors of baPWV.Results The blood pressure,GFR and ACR of the low risk group,the middle risk group,the high risk group and the extremely high risk group were significantly different(P<0.05).The values of baPWV in the four groups increased successively[(1226±312),(1455±275),(1726±181),(1926±282)cm/s;P<0.05];PTH in the four groups increased successively[(28.4±7.4),(31.6±14.1),(45.2±11.4),(53.7±23.4)ng/ml;P<0.05];linear correlation analysis showed that PTH was positively correlated with baPWV(r=0.252,P<0.01).The results of multiple stepwise linear regression analysis showed that age and PTH were independent factors of baPWV(β=0.65,0.36,all P<0.01).Conclusion In hypertensive nephropathy,with the increase of parathyroid hormone,the stiffness of the great arteries increases.Parathyroid hormone levels are associated with arterial stiffness.

关 键 词：高血压肾病 甲状旁腺激素 大动脉僵硬度 

分 类 号：R544.1[医药卫生—心血管疾病] R692[医药卫生—内科学]