PTH在CRF诊治中的应用

The Clinical Aapplication of Determination of Serum Parathyroid Hormone Levels in Diagnosis of Chronic Renal Failure

目的:探讨测定血清中甲状旁腺激素(PTH)的水平在慢性肾功能衰竭(CRF)诊治中的临床意义。方法:测定30例CRF患者血清PTH、25-(OH)VitD3和血钙,与健康人做对照。分别检测30例糖尿病肾病(DN)、高血压肾病患者血清内PTH浓度与血尿素氮(BUN)、血肌酐(Scr)的相关程度。结果:与正常对照组相比,CRF患者血清PTH水平显著升高,25-(OH)VitD3和血钙降低,差异有统计学意义(P<0.05)。DN患者和糖尿病(DM)患者相比较,高血压肾病患者和高血压患者相比较,前者血清PTH水平均比后者要高,且与血BUN、Scr及尿中微量白蛋白(MA)与肌酐(Cr)的比值(MA/Cr)有较好的相关性。结论:CRF导致患者血清PTH浓度升高,测定血清PTH水平可作为判断肾功能的指标之一,更有助于临床对CRF的提早发现和及时治疗,对钙磷代谢的调节评价及预防继发性甲状旁腺功能亢进具有重要的临床意义。

Objective To investigate the clinical significance of the serum parathyroid hormone （PTH） levels in patients with chronic renal failure. Methods Serum PTH, 25-（OH）vitamin D3 and calcium levels were detected in 30 patients with chronic renal failure and 30 controls. Also detected the serum PTH concentration and serum urea nitrogen, serum creatinine in 30 patients with diabetic nephropathy and 30 patients with hypertensive nephropathy. Results Serum PTH levels in chronic renal failure patients were significantly higher than those in controls, but the serum 25-（OH）vitamin D3 and calcium levels were decreased significantly （P〈0.05）. Serum PTH levels in patients with diabetic nephropathy or hypertensive nephropathy were significantly higher than those in diabetics or hypertensives without nephropathy and were positively correlated with the serum urea nitrogen, serum creatinine levels and urine MA/Cr ratio. Conclusion Chronic renal failure would lead to increased concentrations of serum PTH. Serum PTH levelscould be used as an indicator of renal function and were useful in detection and timely treatment of CRF as well as regulation and prevention of secondary hyperparathyroidism.