慢性肾衰竭血液透析患者血清1,25(OH)_(2)D_(3)水平变化及与甲旁亢的相关性

Changes of Serum 1,25(OH)_(2)D_(3) in Patients with Chronic Renal Failure Undergoing Hemodialysis and Its Correlation with Hyperparathyroidism

目的探究慢性肾衰竭血液透析患者血清1,25(OH)_(2)D_(3)水平变化及与甲状旁腺功能亢进(简称“甲旁亢”,HPT)的相关性。方法回顾性分析2018年3月至2019年6月我院收治80例慢性肾衰竭患者的临床资料,其中40例接受血液透析治疗,余40例接受常规治疗,分别为血透组、对照组,治疗3个月后比较两组血清1,25-二羟维生素D[1,25(OH)_(2)D_(3)]、甲状旁腺激素(PTH)水平及随访1年内HPT发生率,并选择Pearson法分析HPT与血清1,25(OH)_(2)D_(3)、PTH水平的相关性。结果治疗后,血透组患血清1,25(OH)_(2)D_(3)、PTH水平明显低于对照组(P<0.05),HPT发生率明显高于对照组(P<0.05);血液透析治疗患者中,发生HPT者的血清1,25(OH)_(2)D_(3)水平低于无HPT者,而PTH水平高于无HPT者(P<0.05);Pearson相关性分析显示,血液透析治疗慢性肾衰竭患者HPT与PTH水平呈正相关,与血清1,25(OH)_(2)D_(3)水平呈负相关(P<0.05)。结论血液透析治疗慢性肾衰竭患者可导致血清1,25(OH)_(2)D_(3)、PTH水平降低,且增加HPT发生风险,HPT与血清1,25(OH)_(2)D_(3)水平密切相关。

Objective To investigate changes of serum 1,25(OH)_(2)D_(3) in patients with chronic renal failure undergoing hemodialysis and its correlation with hyperparathyroidism(HPT).Methods Clinical data of 80 patients with chronic renal failure who were treated in the hospital between March 2018 and June 2019 were retrospectively analyzed.40 patients were treated with hemodialysis(hemodialysis group)and 40 patients were given conventional treatment(control group).After 3 months of treatment,serum 1,25-dihydroxyvitamin D3[1,25(OH)_(2)D_(3)]and parathyroid hormone(PTH)levels and the incidence of HPT within 1 year of follow-up were compared between the two groups.Pearson correlation analysis of HPT,serum 1,25(OH)_(2)D_(3),and PTH was performed.Results After treatment,serum 1,25(OH)_(2)D_(3) and PTH levels in the hemodialysis group were significantly lower than those in the control group(P<0.05),and the incidence of HPT was significantly higher than that in the control group(P<0.05).In the hemodialysis group,serum 1,25(OH)_(2)D_(3) in patients with HPT was lower,and the PTH level was higher than those without(P<0.05).Pearson correlation analysis showed that HPT was positively correlated with PTH levels in patients with chronic renal failure treated with hemodialysis,but was negatively correlated with serum 1,25(OH)_(2)D_(3)(P<0.05).Conclusion Hemodialysis of patients with chronic renal failure can cause decreased serum 1,25(OH)_(2)D_(3) and PTH levels,and increase the risk of HPT.HPT is closely related to serum 1,25(OH)_(2)D_(3).