超声引导下热消融治疗尿毒症继发性甲状旁腺功能亢进症后复发的危险因素  

Risk factors of recurrence after ultrasound-guided thermal ablation for treating uremia secondary hyperparathyroidism

作　　者：甘剑光 邓兆燕[1] 李秋林 杨雪群[1] 覃莹莹 蒋远霞 李坚[1] 杨桢华[2] GAN Jianguang;DENG Zhaoyan;LI Qiulin;YANG Xuequn;QIN Yingying;JIANG Yuanxia;LI Jian;YANG Zhenhua(Department of Nephrology,The First People’s Hospital of Yulin,Yulin 537000,China;Department of Nephrology,The First Affiliated Hospital of Guangxi Medical University,Nanning 530000,China)

机构地区：[1]玉林市第一人民医院肾内科,广西玉林537000 [2]广西医科大学第一附属医院肾内科,广西南宁530000

出　　处：《中国介入影像与治疗学》2023年第12期735-739,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：玉林市科学研究与技术开发计划项目(玉市科20204301)。

摘　　要：目的观察超声引导下热消融治疗尿毒症继发性甲状旁腺功能亢进症(SHPT)后复发的危险因素。方法纳入59例接受超声引导下热消融治疗的尿毒症SHPT患者,其中23例SHPT复发(复发组)、36例未复发(未复发组);比较组间临床资料,以单因素和多因素logistic回归分析筛选复发的独立危险因素。结果组间血清游离甲状腺素(FT4)、尿素、消融后1天血清全段甲状旁腺激素(iPTH)、iPTH 1天下降率、最大结节最大径、消融时间、消融总能量、能量体积比及iPTH 1天下降率≤90%占比差异均有统计学意义(P均<0.05)。尿素升高、能量体积比降低及iPTH 1天下降率≤90%均为SHPT复发的独立危险因素(P均<0.05)。结论热消融治疗尿毒症SHPT后尿素升高、能量体积比降低和iPTH 1天下降率≤90%均为其复发的独立危险因素。Objective To observe the risk factors of recurrence after ultrasound-guided thermal ablation for treating uremia secondary hyperparathyroidism(SHPT).Methods Totally 59 patients with uremia SHPT who underwent ultrasound-guided thermal ablation were enrolled,including 23 cases with(relapse group)and 36 without SHPT recurrence(non relapsed group).Clinical data were compared between groups,univariate and multivariate logistic regression analysis were performed to screen independent risk factors of SHPT recurrence.Results There were significant differences of serum free thyroxine(FT4),urea,intact parathyroid hormone(iPTH)1 day after ablation,1 day decrease rate of iPTH,the maximum diameter of the largest nodule,ablation time,total ablation energy,energy to volume ratio and the proportion of 1 day decrease rate of iPTH≤90%between groups(all P<0.05).Higher urea,lower energy to volume ratio and 1 day decrease rate of iPTH≤90%were all independent risk factors of SHPT recurrence(all P<0.05).Conclusion Higher urea,lower energy to volume ratio and 1 day decrease rate of iPTH≤90%were independent risk factors of recurrence after ultrasound-guided thermal ablation for treating uremia SHPT.

关 键 词：甲状旁腺功能亢进症 继发性 消融技术 超声检查 

分 类 号：R582.1[医药卫生—内分泌] R815[医药卫生—内科学]