血流灌注加血液透析治疗尿毒症继发性甲状旁腺功能亢进症的疗效观察

目的 观察血流灌注加血液透析治疗尿毒症继发性甲状旁腺功能亢进症的疗效。方法将尿毒症继发性甲状旁腺功能亢进患者46例随机分成观察组及对照组，各23例，观察组予1周3次血液灌流串联血液透析治疗；对照组行常规1周3次血液透析治疗。1周后，比较两组血清全段甲状旁腺激素（PTH）和皮肤瘙痒、睡眠及肌无力等症状改善情况。结果血流灌注加血液透析治疗组1周后患者的甲状旁腺激素显著下降，与对照组比较差异有统计学意义（P〈0．05），且皮肤瘙痒、肌无力等症状好转，睡眠改善。结论1周3次血液灌流加血液透析可明显降低尿毒症患者的PTH浓度，较快改善患者症状，表明血流灌注串联血液透析治疗尿毒症继发性甲状旁腺功能亢进症有比较满意的疗效。

Objective To investigate the effects of combined hemoperfusion and hemodialysis in uremia patients complicated with secondary hyperparathyroidism. Methods 46 uremia patients complicated with secondary hyperparathyroidism were randomly devided into two groups ：23 patients were treated with combined hemoperfusion and hemodialysis 3 times in one week ;the other 23 patients were treated with hemodialysis 3 times in one week; The serum parathyroid hormone （PTH） level and clinical manifestation were observed before and after one week treatments. Results The serum parathyroid hormone （PTH） level was reduced significantly in the hemoperfusion and hemodialysis group ; compared with hemodialysis, the hemoperfusion and hemodialysis had better effect in PTH clearance （ P 〈 0.05 ）, meanwhile, some clinical manifestation （ appetite, pruritus, inscmnia） improved. Conclusions 3 times hemoperfusion and hemodialysis in one week can effectively clear PTH and improve clinical manifestation.