阿法骨化醇对维持性血液透析患者甲状旁腺激素的影响及临床意义.doc

《阿法骨化醇对维持性血液透析患者甲状旁腺激素的影响及临床意义.doc》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、阿法骨化醇对维持性血液透析患者甲状旁腺激素的影响及临床意义【摘要】目的观察阿法骨化醇对维持性血液透析患者甲状旁腺激素（iPTH）的影响，并探讨其临床意义。方法24例慢性肾衰竭尿毒症期行维持性血液透析治疗6个月以上患者作为血液透析组（HD组）,同期体检健康人群22例作为健康对照组（Con组）。治疗开始HD组患者口服阿法骨化醇，1Ug/d,元素钙2000mgo共观察12周。Con组患者及HD组患者用药前后均查肾功能及血电解质，用放免法检测iPTH和骨钙素（BGP）。结果用药前HD组与Con组比较，iPTH,BGP及血肌酉干（Cre）明显升高，钙（Ca）降低，血磷（P）升高，差异有统计学

2、意义（P<0.05）o用药后HD组iPTH和BGP明显下降，血钙升高，差异有统计学意义（P<0.05）o结论补充阿法骨化醇，可以降低维持性血液透析患者血清iPTH水平，进而改善肾性骨病，为临床治疗提供了新思路。【关键词】阿法骨化醇;全段甲状旁腺激素;维持性血液透析DOI：10.14163/j.cnki.ll-5547/r.2015.03.002ClinicalsignificaneeandinflueneeofalfacalcidolonintactparathyroidhormoneinmaintenancehemodialysispatientsWANGDong-h

3、ui,DUJuan,GAOHan,etal.ChangchunMedicalCollege,Changchun130031,China[Abstract]ObjectiveToobservetheinflueneeofalfacalcidolonintactparathyroidhormone(iPTH)inmaintenancehemodialysispatients，andtoinvestigateitsclinicalsignificanee.MethodsHemodialysisgroup(HDgroup)contained24pa廿entswithmaintenanceh

4、emodialysisofchronicrenalfailureuremiaformorethan6months,andhealthcontrolgroup(Congroup)contained22healthpeopleinthesametimeperiod・HDgroupreceived1ug/dofalfacalcidoland2000mgofcalciumthroughoraladministration.Theobservationlastedfor12weeks・Therenalfunctionandbloodelectrolytesweredetectedinthet

5、wogroupsbeforeandaftertreatment.Intactparathyroidhormoneandboneglaprotein(BGP)weredetectedbyradioimmunoassaymethod.ResultsHDgrouphadhigheriPTH,BGPandserumcreatinine(Cre),decreasedbloodcalcium(Ca),andincreasedserumphosphate(P)thantheCongroupbeforetreatment.Thediffereneehadstatisticalsignificane

6、e(P<0.05)・TheiPTHandBGPdecreasedandbloodcalciumincreasedinHGgroupaftertreatment,andthediffereneehadstatisticalsignificanee(P<0.05)・ConclusionSupplementofalfacalcidolcanreduceiPTHlevelinmaintenancehemodialysispatients,thereforetheirrenalosteopathycanbeimproved.Thismethodprovidesanewideafo

7、rclinicaltreatment.【Keywords】Alfacalcidol;Intactparathyroidhormone;Maintenancehemodialysis甲状旁腺功能亢进是维持性血液透析患者最常见的远期并发症之一，其过多分泌的血清全段甲状旁腺激素(intactparathyroidhormone,iPTH)也是一*种重要的尿毒症毒素,iPTH过高可引起肾性骨病、心肌病、糖耐量异常、血脂异常、贫血、免疫功能低下、皮肤瘙痒等多种临床表现[1-5]