血液透析联合血液灌流治疗继发性甲状旁腺功能亢进症

Effect of hemodialysis combined with hemoperfusion in treatment of secondary hyperparathyroidism

目的探讨血液透析联合血液灌流治疗继发性甲状旁腺功能亢进的临床疗效。方法选取继发性甲状旁腺功能亢进患者32例，随机分为观察组16例和对照组16例，观察组采用血液透析联合血液灌流治疗，对照组行常规血液透析治疗，比较两组血磷、血钙、血清全段甲状旁腺激素（iPTH）和皮肤瘙痒及肌无力等情况。结果观察组治疗后iPTH较治疗前显著下降（P〈0．05），对照组下降不明显，与治疗前比较差异无统计学意义，两组治疗后血磷较治疗前均显著降低（P〈0．05），而血钙较治疗前均显著升高（P〈0．05），两组治疗后iPTH及血磷比较差异无统计学意义（P〈0．05），而血钙比较差异无显著性。观察组皮肤瘙痒、肌无力等症状明显改善，与对照组比较有统计学意义（P〈0．05）。结论血液透析联合血液灌流治疗继发性甲状旁腺功能亢进是有效的。

Objective To explore the clinical effect of hemodialysis combined with hemoperfusion in treatment of secondary hyperparathyroidism. Methods 32 patients with secondary hyperparathyroidism were selected and randomly divided into two groups：the observation group （16 cases） and the control group （16 cases）. The patients in the observation group were treated with hemodialysis combined with hemoperfusion, and in the control group, the patients were treated with conventional hemodialysis. Then the levels of serum phosphorus, serum calcium, serum intact parathyroid hormone （iPTH） and skin itching, and weakness and so on were compared. Results After treatment,the level of iPTH in the observation group decreased significantly（P 〈0.05） ,but in control group it decreased not obviously,and compared with it before treatment there was no significant difference. After treatment,in the two groups the level of serum phosphorus was significantly lower（ P 〈 0.05 ）, and the level of serum calcium was significantly higher （ P 〈 0.05 ） , and the level of serum phosphorus and iPTH had significant differences between the two groups （ P 〈 0. 05） ,while no significant difference in serum calcium. In the observation group, skin itching, muscle weakness and other symptoms were improved significantly compared with those in the control group （ P 〈 0.05）. Conclusion Hemodialysis combined with hemoperfusion in treatment of secondary hyperparathyroidism was very effective.