终末期肾病患者甲状旁腺激素与肌钙蛋白水平的相关性分析

Correlation Between Parathyroid Hormone and Troponin in Patients with End-stage Renal Disease

目的分析研究终末期肾病(ESRD)患者甲状旁腺激素(iPTH)与肌钙蛋白(cTnI)水平的相关性。方法将我院近两年收集的100例ESRD患者设为ESRD组,统计其中iPTH水平在200ng/L以上的50例患者,并将其作为分析组;对所有患者实施心脏彩超检查,给予分析组患者采用活性维生素D3冲击治疗;将同一时间段在我院体检的60例正常人设为对照组,统计三组检查者的各项生化指标,并分析iPTH和cTnI与心脏结构的关系。结果 ESRD组患者中iPTH上升发生率为76%,cTnI上升发生率为56%,LVH发生率为73%;分析组LVH发生率为88%。ESRD组患者的各项生化指标与对照组存在显著差异,可列入统计学软件分析(P<0.05);分析组治疗前后的各项生化指标有较大差异,可列入统计学软件分析(P<0.05);PTH和cTnI之间呈正比关系,与肾功能无明显联系;而iPTH水平和肾功能受损情况、LVMI呈线性正比关系,无论是治疗还是不治疗,iPTH和cTnI水平均保持为持续性正比关系。结论大多数ESRD患者均会出现继发性高甲状旁腺激素血症,左室肥厚(LVH)和cTnI水平增高也是常见现象,iPTH和cTnI息息相关,通过合理治疗高甲状旁腺激素血症可有效减轻心肌损伤程度,有助于远期预后。

Objective To study the correlation between parathyroid hormone(iPTH) and troponin(cTnI) in patients with end-stage renal disease(ESRD). Methods In our hospital in the past two years collected 100 cases of ESRD were divided into ESRD group, the iPTH level in the 200ng/L statistics more than 50 patients, and as the analysis group; on the implementation of echocardiography in all patients, analysis group were treated with active vitamin D3 treatment will impact at the same time in normal men 60 cases of physical examination in our hospital as the control group, the biochemical indexes of the three groups statistical examination, and analyze the relationship between iPTH and cTnI and heart structure. Results ESRD group of 76 cases of patients with iPTH rise phenomenon, accounting for 76 %; there were cTnI in patients with the rise of the phenomenon, accounting for 56 %; there were 73 cases of patients with LVH, accounting for 73 %; in the analysis group LVH patients in, accounting for 88 %. There are significant differences in the biochemical indexes of the patients in the ESRD group and the control group, can be included in the statistical analysis software(P<0.05); Analysis of the biochemical indexes in different groups before and after treatment, can be included in the statistical analysis software(P<0.05); proportional relationship between PTH and cTnI, no significant correlation with renal function; while the level of iPTH and impaired renal function has a linear relationship, LVMI, whether the treatment also is not a treatment, the levels of cTnI and iPTH keep the persistent positive relationship. Conclusion Most ESRD patients are secondary high parathyroid hormone level, left ventricular hypertrophy(LVH) and cTnI levels is a common phenomenon, iPTH and cTnI are closely related, reasonable treatment of high parathyroid hormone can effectively reduce the extent of myocardial damage and contribute to long-term prognosis.