慢性肾功能衰竭患者血清C-PTH变化与并发症的关系探讨

INVESTIGATION OF THE CHANGE OF SERUM CATBOXYL PARATHYROID HORMONE (C-PTH) IN PATIENT WITH CHRONIC RENAL FAILURE (CRF) AND THE RELATIONSHIP OF C-PTH WITH COMPLICATION

目的 :探讨慢性肾功能衰竭 (CRF)患者血清羧基端甲状旁腺素 (C -PTH)的变化及与钙磷代谢、高血压和贫血的关系。方法 :44例CRF患者用放免法测定血清C -PTH ,血清尿素氮 (BUN)、血清肌酐 (Scr)、血清钙(Ca2 +)、血清磷 (P3 -) ,血红蛋白 (Hb) ,并测量血压计算平均动脉压 (MAP)。结果 :CRF组血清C -PTH、BUN、Scr、P3 -明显高于正常对照组 (P <0 .0 1) ,Ca2 +低于正常对照组 (P <0 .0 5 )。C -PTH与BUN、Scr(P <0 .0 5 )和MAP、P3-(P <0 .0 5 )呈正相关 ,与Ca2 +、Hb无明显相关 (P >0 .0 1)。结论 :CRF患者存在继发性甲状旁腺功能亢进症 (SHPT)、钙磷代谢紊乱和高血压。积极控制高血磷和高血压、纠正代谢性酸中毒、补充钙剂和 1.2 5 (OH) 2 D3 以及甲状旁腺切除部分自体移植术等措施可有效地控制SHPT。

Objective:To investigate the change of serum C-PTH levels in patient with CRF and the relationship of serum C-PTH levers with the metabolism of calcium and phoaphotus,hypertension and anemia.Methods:44 patient with CRF,Immunoradioassay were used to C-PTH,and assay serum blood urea nitrogen(BUN),serum creatinine(Scr),calcium (Ca 2+ ),phosphorus(P 3- ),hemoglobin(Hb),and measure blood pressure to compute mean artery pressure (MAP).Results:The serum C-PTH,BUN,Scr,P 3- in patients with CRF were significantly higher (P<0.01) than the normal subjects,and the Ca 2+ was lower (P<0.05).There were a positive correlation between C-PTH increase and BUN,Scr,P 3- ,MAP(P<0.05),but no obvious relation between C-PTH and Ca 2+ ,Hb (P>0.05).Conclusions:Indication SHPT occurered in patients with CRF,abnormal metabolism of calcium and phoaphotus,hypertension.To rapid control of hyperphosphoremia and hypertension,correction of metabolic acidosis,take calciun and 1.25(OH) 2D 3,parathyroidectomy with partial parathyroid autotransplantion,et al.would be effection for SHPT.