外周血钙磷结合全段甲状旁腺激素对于预测慢性肾衰竭继发甲状旁腺功能亢进的价值

Value of peripheral blood calcium and phosphorus combined with whole segment parathyroid hormone in predicting hyperparathyroidism secondary to chronic renal failure

目的:探讨外周血钙磷结合全段甲状旁腺激素(iPTH)对于预测慢性肾衰竭继发性甲状旁腺功能亢进(SHPT)的价值。方法:选取慢性肾衰竭患者58例作为研究对象,检测血清钙、磷、iPTH含量,调查随访继发性甲状旁腺功能亢进发生情况并进行预测价值分析。结果:在58例患者中,发生SHPT情况18例(继发性甲状旁腺功能亢进组),发生率为31.0%。继发性甲状旁腺功能亢进组的血清磷、iPTH含量高于非继发性甲状旁腺功能亢进组,差异有统计学意义(P<0.05),血清钙含量低于非继发性甲状旁腺功能亢进组,差异有统计学意义(P<0.05)。在两组患者中,Spearman分析显示血清钙、磷、iPTH含量与SHPT存在相关性(P<0.05),Logistic多元回归分析显示血清钙、磷、iPTH含量为导致SHPT发生的重要因素(P<0.05)。ROC曲线分析显示血清钙、磷结合iPTH预测SHPT的曲线下面积为0.814,差异有统计学意义(P<0.05)。结论:慢性肾衰竭患者多伴随有SHPT,可导致血清钙、iPTH水平降低与血清磷水平升高,三者结合检测有利于早期预测SHPT的发生。

Objective To investigate the values of peripheral blood calcium and phosphorus combined with intact parathyroid hormone(iPTH) for predicting secondary hyperparathyroidism(SHPT) in chronic renal failure. Method 58 cases of patients with chronic renal failure were selected as the research objects. The serum calcium, phosphorus, and iPTH levels were detected, and the occurrence of secondary hyperparathyroidism were investigated and followed up and its predictive value analyze.Results There were 18 cases of secondary hyperparathyroidism occurred(secondary hyperparathyroidism group) in the 58 cases, the incidence rate were 31.0%. The levels of serum phosphorus and iPTH in the secondary hyperparathyroidism group were higher than those in the non-secondary hyperparathyroidism group(P<0.05), and the serum calcium content were lower than that in the non-secondary hyperparathyroidism group(P<0.05). In the two groups of 58 patients, Spearman analysis showed that serum calcium, phosphorus, and iPTH levels were correlated with secondary hyperparathyroidism(P<0.05). Logistic multiple regression analysis showed that serum calcium, phosphorus, iPTH levels were the important factors for causing of secondary hyperparathyroidism(P<0.05). ROC curve analysis showed that the area under the curve of serum calcium and phosphorus combined with iPTH to predict secondary hyperparathyroidism were 0.814(P<0.05).Conclusion Patients with chronic renal failure are mostly accompanied by secondary hyperparathyroidism, which can lead to decrease in serum calcium and iPTH levels and increase in serum phosphorus levels. The combined detection of the three are beneficial to early prediction of the occurrence of secondary hyperparathyroidism.