慢性肾脏病患者血清甲状旁腺激素检测的临床应用价值

Clinical application value of the serum parathyroid hormone detection in patients with chronic kidney diseases

目的观察各期慢性肾脏病(CKD)患者的甲状旁腺激素(PTH)、钙、肌酐及磷水平,并分析其临床特征,为早期防治提供依据。方法体检健康者60例纳入健康对照组,CKD患者111例根据临床分期分为Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ期组,检测血清中PTH、磷、钙、肌酐的水平,并进行比较。结果 CKDⅢ、Ⅳ、Ⅴ期患者血清钙水平与健康对照组及CKDⅠ、Ⅱ期患者比较,差异有统计学意义(P<0.05)。CKDⅢ、Ⅳ、Ⅴ期患者血清磷水平与健康对照组及CKDⅠ、Ⅱ期患者比较差异有统计学意义(P<0.05)。CKDⅡ、Ⅲ、Ⅳ、Ⅴ期患者肌酐高于健康对照组及CKDⅠ期患者,差异有统计学意义(P<0.05)。CKDⅢ、Ⅳ、Ⅴ期患者血清PTH水平明显高于健康对照组及CKDⅠ、Ⅱ期患者,差异有统计学意义(P<0.05)。结论Ⅲ期CKD患者就应积极给予降低血磷的综合治疗,以防治继发性甲状旁腺功能亢进发生。

Objective To analyze the levels of parathyroid hormone（PT H） ,calcium ,creatinine and phosphate in different stages of chronic kidney disease（CKD） patients ,and analyze the clinical characteristics of these patients for providing basis for early pre‐vention and cure .Methods A total of 60 healthy persons were selected into control group ,111 patients with CKD were divided intoⅠ 、Ⅱ 、Ⅲ 、Ⅳ 、Ⅴ stage group according to the clinical stages ,detected and analyzed the levels of serum PT H ,phosphate ,calcium and creatinine .Results The levels of serum calcium in the Ⅲ ,Ⅳ ,Ⅴ stage group were significant different with those of the control group and Ⅰ ,Ⅱ stage group（P〈 0 .05） .The levels of serum phosphate in the Ⅲ ,Ⅳ ,Ⅴ stage group were significant different with those of the control group and Ⅰ ,Ⅱ stage group（P〈 0 .05） .The levels of serum creatinine in the Ⅱ ,Ⅲ ,Ⅳ ,Ⅴ stage group were significant higher than those of the control group and Ⅰ stage group（P 〈 0 .05） .The levels of PT H in the Ⅲ ,Ⅳ ,Ⅴ stage group were significant higher than those of the control group and the Ⅰ ,Ⅱ stage group（P 〈 0 .05） .Conclusion Stage Ⅲ CKD patients should give comprehensive treatment actively to reduce serum phosphate for preventing and treating secondary hyperparathyroid‐ism .