慢性肾脏病患者甲状旁腺激素水平与肾功能的关系
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摘要
目的探讨慢性肾脏病(CKD)患者血清甲状旁腺激素(PTH)水平与肾功能的关系。方法选取149例CKD患者,依据我国慢性肾功能衰竭分期方法分为慢性肾功能不全代偿期组、慢性肾功能不全失代偿期组、慢性肾功能衰竭组、尿毒症组,另选取25名体检健康者作为对照组,比较各组PTH水平和生化指标差异,并做相关性分析。结果 CKD各组血清PTH、尿素氮(BUN)、肌酐(Cr)、胱抑素C(CysC)、磷(P)水平均高于对照组(P<0.05),且随CKD分期的增加而逐渐升高(P<0.05);而血清钙(Ca)水平各组间差异无统计学意义(P>0.05);Pearson相关分析显示PTH与BUN、Cr、CysC、P均呈正相关(r值分别为0.442、0.616、0.563、0.376,P<0.01),与Ca呈负相关(r=-0.332,P<0.01)。结论 PTH能够在一定程度上反映CKD的进展,监测慢性肾功能衰竭患者血清PTH水平有助于了解疾病的进展和评估疾病的严重程度。
Objective To investigate the relationship between parathyroid hormone(PTH) level and renal function in patients with chronic kidney disease(CKD). Methods A total of 149 patients with CKD were enrolled.According to the staging method of chronic renal failure in China,the CKD patients were classified into 4 groups(chronic renal insuf?ciency decompensated stage,chronic renal insuf?ciency compensated stage,chronic renal failure and uremia groups). Totally,25 healthy subjects were enrolled as healthy control group. PTH levels and biochemical indexes were compared and analyzed,and correlation analysis was conducted. Results Serum PTH,blood urea nitrogen(BUN),creatinine(Cr),cystatin C(Cys C) and phosphorus(P) levels in CKD group were higher than those in healthy control group(P<0.05),and they were gradually increased with CKD stages(P<0.05).There was no statistical significance for serum calcium(Ca)(P>0.05). Pearson correlation analysis showed that PTH was positively correlated with BUN,Cr,Cys C and P(r=0.422,0.616,0563 and 0.376,P<0.01),and it was negatively correlated with Ca(r=-0.332,P<0.01). Conclusions PTH could re?ect the progress of CKD to some extent. Monitoring serum PTH level of patients with chronic renal failure may be helpful to understand the disease progress and evaluate the disease severity.
Objective To investigate the relationship between parathyroid hormone(PTH) level and renal function in patients with chronic kidney disease(CKD). Methods A total of 149 patients with CKD were enrolled.According to the staging method of chronic renal failure in China,the CKD patients were classified into 4 groups(chronic renal insuf?ciency decompensated stage,chronic renal insuf?ciency compensated stage,chronic renal failure and uremia groups). Totally,25 healthy subjects were enrolled as healthy control group. PTH levels and biochemical indexes were compared and analyzed,and correlation analysis was conducted. Results Serum PTH,blood urea nitrogen(BUN),creatinine(Cr),cystatin C(Cys C) and phosphorus(P) levels in CKD group were higher than those in healthy control group(P<0.05),and they were gradually increased with CKD stages(P<0.05).There was no statistical significance for serum calcium(Ca)(P>0.05). Pearson correlation analysis showed that PTH was positively correlated with BUN,Cr,Cys C and P(r=0.422,0.616,0563 and 0.376,P<0.01),and it was negatively correlated with Ca(r=-0.332,P<0.01). Conclusions PTH could re?ect the progress of CKD to some extent. Monitoring serum PTH level of patients with chronic renal failure may be helpful to understand the disease progress and evaluate the disease severity.
引文
[1]HERON M.Deaths:leading causes for 2011[J].Natl Vital Stat Rep,2015,64(7):1-96.
[2]ZHANG L,WANG F,WANG L,et al.Prevalence of chronic kidney disease in China:a cross-sectional survey[J].Lancet,2012,379(9818):815-822.
[3]康阳阳,刘章锁,刘东伟.中国成人慢性肾脏病患病率荟萃分析[J].中国实用内科杂志,2016,36(9):785-789.
[4]王璐,李汉华,张敏,等.慢性肾脏疾病生化检测项目的风险评估[J].检验医学,2017,32(11):958-961.
[5]郭玮,潘柏申.从K/DOQI 2002到KDIGO 2012慢性肾脏疾病诊疗指南中实验室检测项目相关应用建议的解读[J].检验医学,2015,30(7):663-667.
[6]郭辉.肾功能不全患者血清甲状旁腺素检测水平的变化[J].黑龙江医药科学,2014,37(3):85.
[7]NIKODIMOPOULOU M,LIAKOS S.Secondary hyperparathyroidism and target organs in chronic kidney disease[J].Hippokratia,2011,15(Suppl 1):33-38.
[8]刘东,高卓,魏学明,等.甲状旁腺激素水平对维持性血液透析患者生存质量的影响[J].山西医科大学学报,2014,45(5):384-388.
[9]陆再英,钟南山,谢毅,等.内科学[M].7版.北京:人民卫生出版社,2012:549-558.
[10]张萌萌.甲状旁腺素的生物学研究与成骨作用[J].中国骨质疏松杂志,2017,23(12):1648-1653.
[11]张萌萌.中国老年学学会骨质疏松委员会骨代谢生化指标临床应用专家共识[J].中国骨质疏松杂志,2014,20(11):1263-1272.
[12]杨清柏,纪国新,陈志忠,等.糖尿病慢性肾脏病早期患者继发性甲状旁腺功能亢进症的影响因素分析[J].中国医药导报,2017,14(29):125-127.
[13]丁霏,罗薇,郭英,等.慢性肾脏病初诊患者甲状旁腺激素水平影响因素分析[J].中国实验诊断学,2018,22(11):1942-1945.
[14]YOUNG N,MIKHALKEVICH N,YAN Y,et al.Differential regulation of osteoblast activity by Th cell subsets mediated by parathy roid hor mone and IF N-gamma[J].J Immunol,2005,175(12):8287-8295.
[2]ZHANG L,WANG F,WANG L,et al.Prevalence of chronic kidney disease in China:a cross-sectional survey[J].Lancet,2012,379(9818):815-822.
[3]康阳阳,刘章锁,刘东伟.中国成人慢性肾脏病患病率荟萃分析[J].中国实用内科杂志,2016,36(9):785-789.
[4]王璐,李汉华,张敏,等.慢性肾脏疾病生化检测项目的风险评估[J].检验医学,2017,32(11):958-961.
[5]郭玮,潘柏申.从K/DOQI 2002到KDIGO 2012慢性肾脏疾病诊疗指南中实验室检测项目相关应用建议的解读[J].检验医学,2015,30(7):663-667.
[6]郭辉.肾功能不全患者血清甲状旁腺素检测水平的变化[J].黑龙江医药科学,2014,37(3):85.
[7]NIKODIMOPOULOU M,LIAKOS S.Secondary hyperparathyroidism and target organs in chronic kidney disease[J].Hippokratia,2011,15(Suppl 1):33-38.
[8]刘东,高卓,魏学明,等.甲状旁腺激素水平对维持性血液透析患者生存质量的影响[J].山西医科大学学报,2014,45(5):384-388.
[9]陆再英,钟南山,谢毅,等.内科学[M].7版.北京:人民卫生出版社,2012:549-558.
[10]张萌萌.甲状旁腺素的生物学研究与成骨作用[J].中国骨质疏松杂志,2017,23(12):1648-1653.
[11]张萌萌.中国老年学学会骨质疏松委员会骨代谢生化指标临床应用专家共识[J].中国骨质疏松杂志,2014,20(11):1263-1272.
[12]杨清柏,纪国新,陈志忠,等.糖尿病慢性肾脏病早期患者继发性甲状旁腺功能亢进症的影响因素分析[J].中国医药导报,2017,14(29):125-127.
[13]丁霏,罗薇,郭英,等.慢性肾脏病初诊患者甲状旁腺激素水平影响因素分析[J].中国实验诊断学,2018,22(11):1942-1945.
[14]YOUNG N,MIKHALKEVICH N,YAN Y,et al.Differential regulation of osteoblast activity by Th cell subsets mediated by parathy roid hor mone and IF N-gamma[J].J Immunol,2005,175(12):8287-8295.