难治性继发性甲状旁腺功能亢进症患者肺功能临床分析

Clinical analysis on pulmonary function in patients with refractory secondary hyperparathyroidism

目的研究难治性继发性甲状旁腺功能亢进症(refractory secondary parathyroidism,RSHPT)患者肺功能变化及影响因素的相关性分析。方法应用肺功能仪检测50名患有难治性继发性甲状旁腺功能亢进症需手术治疗的维持性血液透析尿毒症患者(R-SHPT组)肺功能,同时检测同期50名患有继发性甲状旁腺功能亢进症不需手术治疗的维持性血液透析尿毒症患者(非R-SHPT组)肺功能,并且对影响肺功能的因素进行相关性分析。结果 1R-SHPT组肺功能指标残气量、残总比高于非RSHPT组,其余各项指标均低于非R-SHPT组,差异有统计学意义(P<0.05);2R-SHPT组血钙、血磷、碱性磷酸酶均高于非R-SHPT组,差异有统计学意义(P<0.05);而血肌酐、血红蛋白、C-反应蛋白、铁蛋白,2组比较差异无统计学意义(P>0.05)。结论 1难治性继发性甲状旁腺功能亢进症患者肺通气功能、小气道功能、弥散功能均明显下降;2甲状旁腺激素、血红蛋白是影响SHPT患者肺功能的原因。

Objective To evaluate pulmonary fimction and its related factors in patients with refracto- ry secondary hyperparathyroidism （R-SHPT） in maintenance hemodialysis （MHD） patients. Methods Pul- monary function was measured in 50 MHD patients with R-SHPT before parathyroidectomy, and in 50 MHD patients with SHPT in whom parathyroidectomy was not required. Factors affecting pulmonary function in these patients were analyzed. Results @Pulmonary function was significantly lower in R-SHPT group than in SHPT groups （P〈0.05）. @ Serum calcium, phosphorus, and ALP were significantly higher in R-SHPT group than in SHPT group （P〈0.05）, but Scr, Hb, CRP, and ferritin were similar between the two groups （P〉 0.05）. Conclusion @Pulmonary ventilation function and small airway function decreased significantly in R- SHPT grouo. @ iPTH and Hb mav relate to the decrease of pulmonary function in R-SHPT patients.