慢性肾脏病患者甲状旁腺激素同型半胱氨酸检测的临床意义
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摘要
目的:探讨慢性肾脏病患者甲状旁腺激素(PTH)、同型半胱氨酸(Hcy)等指标检测的临床意义。方法:48例慢性肾脏病患者(CKD)按临床诊断分为CKD3期、CKD4期、CKD5期3组,分别检测3组患者的血PTH、Cys C、Hcy、Cr等指标,并进行统计分析。结果:CKD5期组患者血清PTH、Cys C、Hcy、Cr水平均高于CKD4期、CKD3期组,差异均有统计学意义(P <0.05),但CKD4期组患者血清PTH、Cys C、Hcy、Cr水平与CKD3期组相比均无显著性差异(P>0.05)。PTH在CKD5期、CKD4期、CKD3期组阳性率分别为:70.8%、21.4%、20%; Hcy在CKD5期、CKD4期、CKD3期组阳性率分别为:58.3%、7.1%、10%。PTH、Hcy、Cr与Cys C呈正相关(R=0.505、0.855、0.788)。结论:PTH、Hcy等指标联合检测有利于CKD患者疾病的诊断与病情判断,为临床诊疗提供准确的指导。
Objective: To explore the clinical significance of the detection of PTH and Hcy in patients with the chronic kidney disease. Methods: 48 patients with chronic kidney disease (CKD) were divided into three groups: CKD stage 3,CKD stage 4 and CKD stage 5 according to the clinical diagnosis. PTH,Cys C,Hcy and Cr were detected in three groups,and the statistical analysis was conducted. Results: The levels of serum PTH,Cys C,Hcy and Cr in CKD stage 5 group were higher than those in CKD stage 4 and CKD stage3 groups,the difference was statistically significant (P <0.05),but there was no significant difference between CKD stage 4 group and CKD stage 3 group in serum PTH,Cys C,Hcy and Cr levels (P >0.05). The positive rates of PTH in CKD stage 5 group,CKD stage 4 group and CKD stage 3 group were: 70.8%,21.4%,20%; The positive rates of Hcy in CKD stage 5 group,CKD stage 4 group and CKD stage 3 group were: 58.3%,7.1%,10%. PTH,Hcy,Cr and Cys C were positively correlated (R = 0.505、0.855、0.788). Conclusion: The combined detection of PTH,Hcy and other indicators is helpful for the diagnosis and judgment of CKD patients,and provides accurate guidance for clinical diagnosis and treatment.
Objective: To explore the clinical significance of the detection of PTH and Hcy in patients with the chronic kidney disease. Methods: 48 patients with chronic kidney disease (CKD) were divided into three groups: CKD stage 3,CKD stage 4 and CKD stage 5 according to the clinical diagnosis. PTH,Cys C,Hcy and Cr were detected in three groups,and the statistical analysis was conducted. Results: The levels of serum PTH,Cys C,Hcy and Cr in CKD stage 5 group were higher than those in CKD stage 4 and CKD stage3 groups,the difference was statistically significant (P <0.05),but there was no significant difference between CKD stage 4 group and CKD stage 3 group in serum PTH,Cys C,Hcy and Cr levels (P >0.05). The positive rates of PTH in CKD stage 5 group,CKD stage 4 group and CKD stage 3 group were: 70.8%,21.4%,20%; The positive rates of Hcy in CKD stage 5 group,CKD stage 4 group and CKD stage 3 group were: 58.3%,7.1%,10%. PTH,Hcy,Cr and Cys C were positively correlated (R = 0.505、0.855、0.788). Conclusion: The combined detection of PTH,Hcy and other indicators is helpful for the diagnosis and judgment of CKD patients,and provides accurate guidance for clinical diagnosis and treatment.
引文
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[2]刘莉华,秦淑国,马胜银,等.血清同型半胱氨酸胱抑素维生素B6及炎症因子在糖尿病肾脏病中的临床意义[J].安徽医学,2018,39(3):278~281.
[3]National Kidney Foundation.K/DOQI clinical practice guidelines for chronic kidney disease:evaluation,classification,and stratification[J].Am Kidney Dis,2002,39(2 Suppl 1):S1~266.
[4]李锦芬,李晓忠.血清胱抑素C纤维蛋白原及24h尿蛋白定量对紫癜性肾炎儿童肾损伤程度的评估效果[J].安徽医学,2018,39(2):186~188.
[5]Ix JH,Anderson CA,Smits G,Persky MS,Block GA.Effect of dietary phosphate intake on the circadian rhythm of serum phosphate concentrations in chronic kidney disease:a crossover study[J].The American Journal of Clinical Nutrition,2014,100(5):1392~1397.
[6]龙林会,张德文,陈芳.慢性肾功能衰竭患者血清甲状旁腺激素与胱抑素C及同型半胱氨酸的相关性研究[J].现代医药卫生,2015,31(5):673~675.
[7]Jakovljevic B,Gasic B,Kovacevic P,et al.Homocystein as a risk factor for developing complications in chronic renal failure[J].Mater Sociomed,2015,27(2):95~98.