慢性肾脏病继发甲状旁腺功能亢进症50例临床分析

Clinical analysis on 50 chronic kidney disease patients complicated with secondary hyperparathyroidism

目的探讨慢性肾脏病(CKD)合并继发性甲状旁腺功能亢进症(SHPT)患者血清甲状旁腺激素(PTH)、钙磷水平的变化及其治疗对策。方法 50例CKD合并SHPT患者随机分为治疗组(30例)和对照组(20例),对照组采用常规治疗,治疗组在对照组基础上加用骨化三醇、磷结合剂及低钙透析液治疗。检测两组血清PTH、血清碱性磷酸酶(ALP)、血清钙、磷浓度,计算钙磷乘积。结果与对照组和治疗前相比,治疗组治疗期间的PTH、ALP水平和钙磷乘积下降(P<0.05),治疗20周后心血管疾患、感染、肾性骨病、贫血等并发症减少(P<0.05)。结论积极调整CKD患者钙磷代谢及血清PTH、ALP水平,对减少CKD患者并发症有重要意义。

Objective To investigate the changes of serum parathyroid hormone（PTH） and the disorders of phosphorus and calcium metabolism in chronic kidney disease（CKD） patients complicated with secondary hyperparathyroidism（SHPT） and the therapeutic regime. Methods Fifty CKD patients complicated with SHPT were randomly divided into two groups.Group B（20 cases） was treated by conventional method and group A（30 cases） was given additional calcitriol,phosphate binder and low calcium dialysis solutions.Serum PTH,alkaline phosphatase（ALP） and concentrations of calcium,phosphorus were detected and calcium-phosphorus product was calculated. ResultsCompared with group B and before treatment,the levels of serum PTH,ALP and calcium-phosphorus product were decreased during treatment period and the incidence of complications such as cardiovascular diseases,infection,renal osteopathy and anemia was lower in 20 weeks after treatment in group A（P0.05）. Conclusion It is important to adjust the levels of serum phosphorus,calcium, PTH and ALP in CKD patients for reducing complications.