不同血液净化方法对肾衰合并继发性甲状旁腺功能亢进患者血清甲状旁腺激素水平的影响

Effect of different blood purification methods on parathyroid hormone in maintenance hemodialysis patients with secondary hyperparathyroidism

目的探讨不同血液净化方法对慢性肾衰竭(CRF)合并继发性甲状旁腺功能亢进(SHPT)患者血清甲状旁腺激素水平的影响。方法将53例CRF合并SHPT患者随机分为血液透析(HD)组16例,血液透析滤过(HDF)组22例,血液灌流+血液透析(HP+HD)组15例,比较治疗前及治疗后6个月血清甲状旁腺激素(PTH)和钙、磷水平的变化。结果治疗后6个月与治疗前比较,HDF组、HP+HD组PTH水平明显下降(P均<0.01),HP+HD组血磷水平明显下降(P<0.05);三组治疗后血钙水平无明显变化。结论HP+HD与HDF均能够使CRF合并SHPT患者PTH水平下降。

Objective To compare the effect of different blood purification methods on parathyroid hormone in maintenance hemodialysis patients with secondary hyperparathyroidism.Methods Fifty-three patients on maintenance hemodialysis were randomly divided into three groups： hemodialysis group（HD group）,hemodiafiltration group（HDF group） and hemoperfusion plus hemodialysis group（HP＋HD group）.Serum phosphorus,calcium and serum PTH levels were observed before and after six month-continuing treatment.Results After being treated,the levels of serum PTH in HDF group and HP＋HD group decreased significantly（all P0.01）,so did the level of serum phosphorus in HP＋HD group（P0.05）.There were no changes of serum calcium in three groups.Conclusion Hemodiafiltration and hemoperfusion plus hemodialysis can effectively clear PTH in maintenance hemodialysis patients with secondary hyperparathyroidism.