透析患者甲状旁腺素水平的临床观察

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1、CHINESEJ．DIAL．&ARTIF．ORGANSVo1．2lNO．2JUN．2010透析患者甲状旁腺素水平的临床观察张怡玲，田丽，盛丹红【摘要】目的探讨透析患者在透析治疗后的血清甲状旁腺素(iVI'H)水平状况及其相关因素。方法对98例透析患者采用电化学发光免疫分析法检测血清iPTH水平，并横断面调查透析患者的骨痛情况及超声检查甲状旁腺。结果透析患者血清iPTH水平与血磷、透龄及血白蛋白均呈正相关(r=-7．465，P<0．001；r=4．523，P<0．02；r=7．437，P<0．001)。HD组血磷及iPTH水平较PD组明显增高(尸<0．002

2、、0．005)，HD组血磷≥2．6nunol／L的患者血清iPTH水平较<2．6mmol／L的患者血清iPTH水平明显增高(尸<0．05)，透析≥3年的血清iPTH水平比<3年的明显增高(P0．05)。透析患者血白蛋白≥3．5g／g较<3．5的血清iPTH水平明显增高(P<0．05)。HD组骨痛及甲状旁腺瘤发生率明显高于PD组(分别为46．6％和4．8％，X=19．390，t<0．005；10．5％和0％，X=4．597，t<0．05)。HD组有骨痛患者较无骨痛患者的血清iPTH水平明显增高(O．01)。结论HD对

3、血清iPTH的清除明显低于PD，骨痛及甲状旁腺瘤发生率也较高，HD3年以上且血磷≥2．6mmol／L的患者更应该注意继发性甲状旁腺素功能亢进。【关键词】甲状旁腺素；血液透析；腹膜透析中图分类号：R692．5文献标志码：A文章编号：1005—0809(2010)02—0022—04ClinicalObservationontheParathyroidHormoneLevelsofHemodialysisPatientsZHANGYi—ling，TIANLi，SHENGDan-hung(TheSecondAffiliatedHospitalofDalianMe

4、dicalUniversity,116027Daliw~，China)【Abstract】0bjectiveTodiscusstheiwHleve1andrelatedfactorsofhemodialysispatientsafterthehemodialysis．MethodsTodetecttheiPTHlevelof98hemodialysispatientswithelectrochemiluminescenceimmunoassayandsurveytheostealgiasituationofhemodialysispatientsandch

5、ecktheparathyroidbyultrasound．ResultsiPTHlevelofhemodialysispatientshadapositivecorrelationwithphosphorus，hemodialysisperiodandalbumin(r=7．465，P<0．0叭；r=4．523，P<0．02；r=7．437，P<0．On1)．PhosphorusandiPTHlevelinHDgroupinoreasedsignificantlycomparedwiththatofPDgroup(P<0．002．0．005)；iPTHl

6、evelofthepatientswithphosphorus≥2．6mmol／LinHDgroupincreasedsignificantlycomparedwiththatofPDgroup；iPTHlevelwiththehemodialysisperiod≥3yearsincreasedsignificantlycomparedwiththatwiththehemodialysisperiod<3years(P<0．05)，withoutstatisticalsignificanceinPDgroup．iPTHlevelofthepatientsw

7、ithalbumin≥3．5g／Lcomparedwiththatwith<3．5g／Lincreasedsignificantly(P<0．05)．TheincidenceofostealgiaandparathyroidtumorinHDgroupwassignificantlyhigherthanthatofPDgroup(46．6％和4．8％，X=19．390，t<0．005；10．5％和0％，X=4．597，t<0．05)．iPTHlevelofthepatientswithostealgiaincreasedsignificantlycompa

8、redwiththatwithoutostealgia(P<0．O