肾病综合征患儿及罗钙全治疗前后血清PTH和25-(OH)D_3水平的变化

SERUM PTH AND 25OHD_3 LEVELS IN NEPHROTIC CHILDREN AND BEFORE AND AFTER CALCITROIL TREATMENT

采用放射免疫分析法对17例肾功能正常的肾病综合征（NS）患儿甲状旁腺激素（PTH）和25－（OH）D3进行了测定，并观察了罗钙全短程口服冲击治疗前后它们的动态变化。结果表明，NS患儿血钙水平比正常对照组低，血清PTH升高，25－（OH）D3降低，提示NS患儿存在低钙血症、甲状分腺功能亢进和维生素D代谢异常。罗钙全口服冲击治疗后NS患儿血钙磷和PTH水平与正常对照组比较无显著性差异，提示NS患儿的钙磷代谢异常及PTH异常分泌得到一定程度的纠正。

In this study, we measured with radioimmunoasoy the concchtrations of serum PTH, 25 (OH ) D3, calcium (Ca), phocphate (P) and alkaline phosphatase (ALP) in 17 patients with nephrotic syndrome and 18 healthy children. We also observed the in fluences of short - term oral calcitroil pulse theray on these of the nephrotic children. This study dernonstrates that: (1 ) there are decreased serum Ca and 25 (OH) D3 levels, and elevated PTH and ALP levels in nephrotic children. (2) after calcitroil - treatment the concentrations of serum CA and P markedly increw,ed and serurn ALP and PTH levels wer decreased. These results suggest that there were abnormalities of the Ca - P and vitamin D metabolism and excessive PTH secretion in nephrotic children with long - term, hyperphysiological - dose glucocorticoid treatment and normal renal function. These abnormalities may be righted by oral calcitroil pulse therapy.