慢性肾衰患者继发性甲旁亢对血红蛋白影响的临床研究  

Clinical Study of the Effect of Secondary Hyperparathyroidism on Hemoglobin in the Patients with Chronic Renal Failure

作　　者：黄业华[1] 刁秀竹[1] 陈薇[1] 柴树人[1] 

机构地区：[1]安徽省立医院肾内科,合肥市230001

出　　处：《医学理论与实践》2003年第6期645-646,共2页The Journal of Medical Theory and Practice

摘　　要：目的:研究慢性肾衰患者继发性甲状旁腺功能亢进对血红蛋白的影响。方法:随机选择48例慢性肾衰患者,于入院后次日晨(治疗前)采空腹静脉血测定血清甲状旁腺素(PTH)、肌酐(Cr)、尿素氮(Bun)、钙、磷和血红蛋白(Hb)等。结果:慢性肾衰患者的Hb与PTH呈负直线相关关系,与Cr、Bun、磷亦呈负直线相关关系(均P<0.01),与钙呈正直线相关关系(P<0.01);而PTH与血Cr、Bun、钙、磷无直线相关关系。慢性肾功能不全失代偿期患者与尿毒症期患者比较,前者Hb较高(P<0.01);两组间PTH无显著差异。结论:慢性肾衰患考的高PTH血症,抑制骨髓造血功能,使患者贫血加重;尿毒症终末期患者,低钙血症并非是继发性甲状旁腺功能亢进的必要条件,高PTH血症可能是甲状旁腺自主性分泌增多所致。Objective:To study the effect of secondary hyperparathyroidism on hemoglobin in the patients with chronic renal failure. Methods:48 patients with chronic renal failure were chosen randomly, the fasting blood parathormone(PTH) , serum creatinione (Cr),blood urea nitrogen(Bun) , calcium, phosphate and hemoglobin (Hb) were determined next morning of admission (before treating) . Results: In the patients with chronic renal failure, Hb was negatively correlated with PTH, Cr, Bun and phosphate( all, P < 0.01) ;but positively correlated with calcium( P < 0.01) ;PTH was not correlated with Cr, Bun,calcium and phosphate.Hb in the patients of chronic renal insufficiency in the phase of decompensation was higher than that in the phase of urinemia ( P < 0.01) ;PTH had no significant differences between two groups. Conclusions: Hyperparathormonemia of patients with chronic renal failure can inhibit hemopoietic function of marrow, thus aggravating anemia. Hypoalcemica is not a necessary condition of secondary hyperparathyroidism in the patients with the terminal urinemia. Hyperparathormonemia may be resulted from idiopathic hypersecretion of parathyroid.

关 键 词：慢性肾功能衰竭 血红蛋白 继发性甲状旁腺功能亢进 测定 肌酐 尿素氮 

分 类 号：R692.5[医药卫生—泌尿科学] R582.1[医药卫生—外科学]