慢性肾功能衰竭患者血清甲状旁腺激素与胱抑素C及同型半胱氨酸的相关性研究

Correlation study on the serum PTH and cystatin C,homocysteine in patients with chronic renal failure

目的探讨慢性肾功能衰竭（CRF）患者甲状旁腺激素（PTH）与胱抑素C（Cys C）、同型半胱氨酸（Hcy）之间的相关性。方法随机选取该院2014年1-7月80例CRF患者（观察组）和50例健康体检者（对照组）,检测其血清PTH、Cys C、Hcy、钙、磷、肌酐（Cr）及尿素氮（BUN）水平,计算内生肌酐清除率,同时回顾性分析其相关性。结果 （1）观察组患者血清PTH、Cys C、Hcy、磷、Cr及BUN水平均高于对照组,差异均有统计学意义（P〈0.01）,而钙水平较对照组显著降低,差异有统计学意义（P〈0.05）。（2）肾功能失代偿期、肾衰竭期、尿毒症期患者血清PTH、Cys C、Hcy,以及BUN、内生肌酐清除率水平比较,差异均有统计学意义（P〈0.05）。（3）CRF患者血清PTH与Cys C、Hcy、钙、磷、BUN、Cr呈正相关（r=0.335 6、0.256 3、0.322 2、0.149 3、0.229 8、0.356 8）,与内生肌酐清除率水平呈负相关（r=-0.501 6）;CRF患者血清Hcy与Cr水平呈正相关（r=0.280 6）,与内生肌酐清除率呈负相关（r=-0.436 2）。（4）CRF患者中,钙阳性率为52.5%（42/80）,磷阳性率为81.2%（65/80）,PTH阳性率为97.5%（78/80）。结论血清PTH水平可以作为诊断CRF的重要参考指标。

Objective To investigate the correlation between the parathyroid hormone PTH and cystatin C（Cys C）,homocysteine（Hcy） in patients with chronic renal failure（CRF）. Methods A total of 80 patients with CRF（the observation group）from January to July in 2014 and 50 healthy examinees of this hospital（the control group） were randomly selected to detect their serum PTH,Cys-C,Hcy phosphorus,Cr and BUN concentrations,calculating the endogenous creatinine clearance rate and analyzing their correlation retrospectively. Results（1）The concentrations of serum PTH,Cys C,Hcy,phosphorus,Cr and BUN in the observation group were higher than those of the control group. The difference had statistically significant（P〈0.01）,and calcium level was lower in the control group,whose difference was statistacally significant（P〈0.05）;（2）There was statistical significance in PTH,Cys-C,Hcy,BUN and Scr during the stage of renal decompensation,renal failure and uremia,whose difference was statistically significant（P〈0.05）;（3）The serum PTH concentration for CRF patients showed positive relation with Cys C,Hcy,calcium,phosphorus,BUN,Cr（r=0.335 6,0.256 3,0.322 2,0.149 3,0.229 8,0.356 8） while a negative correlation with Scr concentrstion（r=-0.501 6）;the serum Hcy of CRF patients demonstrated a positive correlation with Cr concentration（r=0.280 6）,and a negative correlation with Scrconcentration（r=-0.436 2）;（4）The positive rate of calcium,phosphorus and PTH proportion among CRF patients was 52.5%（42/80）,81.3%（65/80） and 97.5%（78/80） respectively. Conclusion The serum PTH concentrations was the major reference parameter as diagonsis of CRF.