慢性肾衰患者PTH水平及相关因素的研究

INVESTIGATION OF PARATHYROID HORMONE LEVELS AND ASSOCIATED FACTORS IN PATIENT WITH CHRONIC RENAL FAIURE

目的 :探讨慢性肾衰患者的PTH水平及相关因素。方法 :采用放免法检测尿毒症患者的PTH水平及其与肾性骨病、高血压的关系 ,以及血液滤过和血液透析对尿毒症患者PTH水平的影响。结果 :尿毒症早期与透析患者的iPTH分别为 (12 0 .3± 6 3.5 )pg/ml、(2 75 .6± 2 5 6 .3) pg/ml,升高明显 ,但与血压无明显的相关性 ,FDF与HD患者的PTH水平无差异 ,根据PTH水平结合钙、磷、AKP基本可明确肾骨病的类型。结论 :尿毒症患者的PTH明显升高 ,长期HDF对尿毒症患者的PTH水平无影响 ,尿毒症患者的PTH水平对明确肾性骨病的类型非常有意义。

Objective: To investigate intact parathyroid hormone (iPTH) levels and associated factors in patients with chronic renal failure. Methods: iPTH was measured of patient with chronic renal failure using immunoradioassay. iPTH levels were compared with respect to renal bone disease and hypertention. Hemodialysis and hemodiafiltration affected to iPTH levels is evatuated. Results: Ipth levels in uremic patients in early stage (120.3±63.5pg/ml) and in dialysis patients (275.6±256.3pg/ml) was higher much than that in normal control (15～75pg/ml). No correlation was found between iPTH levels and hypertention. iPTH levels in hemodiafiltration and in hemodialysis was not significant difference. According as iPTH levels and the levels of serum calcium, phosphorus, AKP, renal osteodystrophy may be classified. Conclusions: PTH levels of patient with chronic renal failure were high markedly. Long-term hemodiafiltration don't affected to PTH levels in uremic patient. PTH levels of uremic patient are very significant on determining classification of renal osteodystrophy.