儿童原发性肾病综合征血清全段甲状旁腺激素平变化及与25羟维生素D的关系

Correlation between the Intact Parathyroid Hormone （iPTH）Levels of Children Primary Nephrotic Syndrome （PNS） and 25 Hydroxy Vitamin D

[目的]了解儿童原发性肾病综合征（Primary nephrotic syndrome，PNS）血清全段甲状旁腺激素（intact PTH，iPTH）的水平及与25羟维生素D[25 hydroxy vitamin D，25（0H）D]之间的关系，探讨PNS患儿甲状旁腺功能的状态。[方法]选择2013年6月至2015年3月本院收治的临床资料完整的PNS患儿131例作为研究对象（观察组），选择同期60例健康体检者为对照组。分析其血清iPTH水平及与血清25（OH）D的关系。[结果]①初发组25（OH）D为（28．31±16．67）nmol／L低于复发组的（38．99±21．41）nmol／L，差异有统计学意义（P〈0．05）；非频复发iPTH为（2．48±1．50）pmol／L低于频复发的（3．83±2．35）pmol／L，差异有统计学意义（P〈0．05）。②Pearson相关分析显示，复发组低iPTH组，血iPTH与25（0H）D呈正相关（r=0．4737，P〈0．05），与钙磷乘积呈正相关（r=0．5046，P〈0．05）。③4例伴有甲状旁腺功能减低症的PNS患儿，随访4个月至1年半甲状旁腺功能均恢复。[结论]①PNS患儿部分存在血清iPTH水平降低；②血清iPTH水平与血磷、钙磷乘积及25（OH）D水平相关；③PNS出现的甲状旁腺功能减退的现象可能是暂时性的，予以补钙和骨化三醇治疗后可恢复。

[Objective] To understand the correlation between the intact parathyroid hormone（iPTH）levels of children primary nephrotic syndrome （PINS） and 25 hydroxy vitamin D（ 25 （OH） D） so as to investigate the status of parathyroid function in children with PNS.[Methods]One hundred and thirty-one PNS cases with complete clinical data in our hospital from June 2013 to March 2015 were enrolled as the study group,and 60 healthy check-up cases in the same period of time were enrolled as the control group. The relationship between serum iPTH levels and serum 25 （OH） D were analyzed .[Results] （1）The 25 （OH） D of the primary group （28.31±16.67） /L nmol was lower than that of the recurrence group （38.99 ±21.41 ） / L nmol, the difference was statistically significant （ P 〈 0.05 ） ; the iPTH of the non frequent recurrence （2.48 ±1.50） was lower than that of the frequent recurrence （3.83±2.35） pmol/L, the difference was statistically significant （ P 〈0.05）. （2） Pearson correlation analysis showed that blood iPTH was positively correlated with 25 （OH） D （ r = 0.4737, P 〈0.05） in the low the iPTH group of the recurrence group, and was positively correlated with the product of calcium and phosphorus, （ r = 0.5046, P 〈0.05）. （3） 4 cases with PNS were followed up for 4 months to one year and a half, and the function of the parathyroid gland was recovered.[Conclusion] （1） Children with PNS present a lower level of serum iPTH partially. （2） Serum iPTH level is correlated with serum phosphorus, the product of calcium and phosphorus and 25 （OH） D levels;（3） Decline phenomenon of PNS parathyroid function may be temporary, and is recoverable after calcium supplements and treatment of calcitriol.