慢性肾脏病继发性甲状旁腺功能亢进症患者治疗前后生活质量的分析

Analysis of life quality of chronic kidney disease patients with secondary hyperparathyroidism before and after the treatment

目的:观察慢性肾脏病(CKD)患者并发继发性甲状旁腺功能亢进症(SHPT)时,其生活质量有否影响及其程度。方法:选择42例CKD患者,根据甲状旁腺素(i PTH)水平分为A组(10例)、B组(11例)、C组(12例)和D组(9例)。针对SHPT的规律治疗和根据患者不同情况给予其它药物治疗方案,已进展到尿毒症期的患者给予血液透析或腹膜透析治疗。治疗前后,4组患者分别填写SF-36生活质量评价量表,比较其生活质量变化。结果:治疗后,4组患者的生活质量各维度得分较治疗前明显提高(P<0.05);仅有A组患者在躯体功能和社会功能两个维度上的得分差异无统计学意义。通过相关分析得出i PTH与患者的生理健康和心理健康均呈高度负相关,r值分别为-0.832、-0.801;通过控制患者的血肌酐和血清白蛋白水平的偏相关分析可知i PTH与其生理健康和心理健康均呈显著负相关,r值分别为-0.783、-0.766、-0.753、-0.737。结论:SHPT对CKD患者的生活质量有显著影响,治疗后患者生活质量明显改善。

Objective： To investigate changes of life quality of the chronic kidney disease（ CKD） patients with secondary hyperparathyroidism（ SHPT）. Methods： Forty-two CKD patients were divided into A,B,C and D groups by the level of parathyroid hormone（ iPTH）,and given other drug treatments based on SPHT and the patient conditions. For those with uremia,hemodialysis or peritoneal dialysis was performed. The patients completed the SF- 36 questionnaire before and after the treatment,and the change of living quality was observed. Results： After the treatment,the score of the four groups patients in every aspects of SF-36 questionnaire was significantly higher than that before the treatment（ P〈0.05）,and only the scores of A group patients had no significant differences in body function and social function. By correlation analysis,iPTH was highly negatively correlated with physical health and mental health（ r =-0.832,r =-0.801,respectively）. Bypartial correlation analysis of the levels of serum creatinine and serum albumin,iPTH was significantly negatively correlated with physical health and mentalhealth（ r =- 0.783,r =- 0.766,r =- 0. 753,r =- 0. 737,separately）. Conclusions： SHPT could improve obviously the life quality of the CKD patients.