中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2014年
15期
2307-2309
,共3页
朱明久%秦丽%叶爱%黄金波
硃明久%秦麗%葉愛%黃金波
주명구%진려%협애%황금파
慢性肾脏病%贫血%甲状旁腺素%红细胞生成素%骨化三醇
慢性腎髒病%貧血%甲狀徬腺素%紅細胞生成素%骨化三醇
만성신장병%빈혈%갑상방선소%홍세포생성소%골화삼순
Chronic kidney disease%Anemia%Parathyriod hormone%Erythropoietin%Calcitriol
目的：探讨慢性肾脏病（ CKD ）甲状旁腺素（ PTH ）与肾性贫血的关系。方法测定126例CKD3～5期患者血PTH、血红蛋白（ Hb）、红细胞比容（ Hct）、尿素氮（ BUN）、肌酐（ Cr）水平及维持性血液透析（MHD）患者42例经重组人促红细胞生成素（rhEPO）、骨化三醇-1．25（OH）2D3治疗3个月后变化。结果CKD3期PTH明显升高，CKD4期、CKD5期升高更显著；血PTH与BUN、Cr呈线性正相关（P＜0．01），与内生肌酐清除率（Ccr）、Hb呈线性负相关（P＜0．01）。 MHD患者经rhEPO、1．25（OH）2D3治疗3个月后，根据Hct变化，治疗有效73．8％，无效26．2％。有效组与无效组比较PTH、Hb、Hct差异均有统计学意义（P＜0．01），且PTH下降，Hb、Hct升高。结论 CKD患者随着肾功能下降，血PTH升高。高PTH血症加重肾性贫血且使EPO疗效差，1．25（OH）2D3能降低高PTH血症，随高PTH血症的纠正，肾性贫血得到改善。
目的：探討慢性腎髒病（ CKD ）甲狀徬腺素（ PTH ）與腎性貧血的關繫。方法測定126例CKD3～5期患者血PTH、血紅蛋白（ Hb）、紅細胞比容（ Hct）、尿素氮（ BUN）、肌酐（ Cr）水平及維持性血液透析（MHD）患者42例經重組人促紅細胞生成素（rhEPO）、骨化三醇-1．25（OH）2D3治療3箇月後變化。結果CKD3期PTH明顯升高，CKD4期、CKD5期升高更顯著；血PTH與BUN、Cr呈線性正相關（P＜0．01），與內生肌酐清除率（Ccr）、Hb呈線性負相關（P＜0．01）。 MHD患者經rhEPO、1．25（OH）2D3治療3箇月後，根據Hct變化，治療有效73．8％，無效26．2％。有效組與無效組比較PTH、Hb、Hct差異均有統計學意義（P＜0．01），且PTH下降，Hb、Hct升高。結論 CKD患者隨著腎功能下降，血PTH升高。高PTH血癥加重腎性貧血且使EPO療效差，1．25（OH）2D3能降低高PTH血癥，隨高PTH血癥的糾正，腎性貧血得到改善。
목적：탐토만성신장병（ CKD ）갑상방선소（ PTH ）여신성빈혈적관계。방법측정126례CKD3～5기환자혈PTH、혈홍단백（ Hb）、홍세포비용（ Hct）、뇨소담（ BUN）、기항（ Cr）수평급유지성혈액투석（MHD）환자42례경중조인촉홍세포생성소（rhEPO）、골화삼순-1．25（OH）2D3치료3개월후변화。결과CKD3기PTH명현승고，CKD4기、CKD5기승고경현저；혈PTH여BUN、Cr정선성정상관（P＜0．01），여내생기항청제솔（Ccr）、Hb정선성부상관（P＜0．01）。 MHD환자경rhEPO、1．25（OH）2D3치료3개월후，근거Hct변화，치료유효73．8％，무효26．2％。유효조여무효조비교PTH、Hb、Hct차이균유통계학의의（P＜0．01），차PTH하강，Hb、Hct승고。결론 CKD환자수착신공능하강，혈PTH승고。고PTH혈증가중신성빈혈차사EPO료효차，1．25（OH）2D3능강저고PTH혈증，수고PTH혈증적규정，신성빈혈득도개선。
Objective To explore the relationship of serum parathyriod hormone ( PTH) level with renal ane-mia in patients with chronic kidney disease (CKD).Methods Serum levels of PTH,Hb,Hct,BUN,Cr were observed in 126 patients with CKD at stages 3-5,the changes of 42 patients in maintenance hemodialysis(MHD) with recombi-nant human erythropoietin (rhEPO) and calcitriol-1.25(OH)2D3 treatment for three months were determined. Results The serum PTH level was significantly increased in CKD patients at stage 3 and more in CKD patients at stage 4 and 5.There were positive relationship between blood PTH and BUN ,Cr(P<0.01),but a negative relation-ship between PTH and Ccr,Hb(P <0.01).42 patients of MHD treated with rhEPO,1.25(OH)2D3 after three months,according to the changes of HCT ,the effective rate was 73.8% and the ineffective rate was 26.2%.The PTH,Hb,HCT of the effective group had statistically significant differences compared with the ineffective group ( all P<0.01).Hb and Hct significantly increased and PTH significantly decreased in the effective group .Conclusion CKD patients had decreased renal function ,elevated blood PTH .High serum PTH might aggravate renal anemia and fail to respond to rhEPO.The high serum PTH corrected by using 1.25(OH)2D3 might improve renal anemia,with high plasma PTH correcting .
