中华临床医师杂志(电子版)
中華臨床醫師雜誌(電子版)
중화림상의사잡지(전자판)
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
23期
10563-10566
,共4页
肾功能衰竭,慢性%甲状旁腺功能亢进症,继发性%退缩人综合征
腎功能衰竭,慢性%甲狀徬腺功能亢進癥,繼髮性%退縮人綜閤徵
신공능쇠갈,만성%갑상방선공능항진증,계발성%퇴축인종합정
Kidney failure,chronic%Hyperparathyroidism,secondary%Shrinking man syndrome
目的:分析慢性肾衰竭继发性甲状旁腺功能亢进(SHPT)合并退缩人综合征(SMS)患者的临床特点及相关性因素。方法选取在我院肾内科住院并行甲状旁腺全切术的SHPT患者70例为研究对象,按身高较发病前是否缩短分为退缩组和非退缩组,收集一般资料,所有患者均行甲状旁腺全切术,检测患者血甲状旁腺激素(PTH)、血磷(P)、血钙(Ca)、碱性磷酸酶(ALP)、成纤维细胞生长因子-23(FGF-23)水平,分析合并SMS的影响因素。结果70例SHPT患者中共有50例合并SMS,发生率为71.4%;退缩组患者透析龄(t=8.368,P=0.000)、血PTH(t=5.814,P=0.000)、血P(t=3.470,P=0.001)、血ALP(t=7.985,P=0.000)、血FGF-23(t=2.128,P=0.037)水平明显高于非退缩组;相关性分析表明,退缩组患者身高缩短与透析龄(r=0.421,P=0.002)、PTH(r=0.418,P=0.003)、ALP(r=0.596, P=0.000)、FGF-23水平(r=0.875,P=0.000)均呈正相关,与血Ca呈负相关(r =-0.394,P=0.005),而与血P无相关性(r=0.029,P=0.061);术后病理证实SMS患者甲状旁腺组织增生以结节性增生为主。结论 SHPT合并SMS的发生主要与透析龄、血PTH、ALP、Ca及FGF-23水平相关。
目的:分析慢性腎衰竭繼髮性甲狀徬腺功能亢進(SHPT)閤併退縮人綜閤徵(SMS)患者的臨床特點及相關性因素。方法選取在我院腎內科住院併行甲狀徬腺全切術的SHPT患者70例為研究對象,按身高較髮病前是否縮短分為退縮組和非退縮組,收集一般資料,所有患者均行甲狀徬腺全切術,檢測患者血甲狀徬腺激素(PTH)、血燐(P)、血鈣(Ca)、堿性燐痠酶(ALP)、成纖維細胞生長因子-23(FGF-23)水平,分析閤併SMS的影響因素。結果70例SHPT患者中共有50例閤併SMS,髮生率為71.4%;退縮組患者透析齡(t=8.368,P=0.000)、血PTH(t=5.814,P=0.000)、血P(t=3.470,P=0.001)、血ALP(t=7.985,P=0.000)、血FGF-23(t=2.128,P=0.037)水平明顯高于非退縮組;相關性分析錶明,退縮組患者身高縮短與透析齡(r=0.421,P=0.002)、PTH(r=0.418,P=0.003)、ALP(r=0.596, P=0.000)、FGF-23水平(r=0.875,P=0.000)均呈正相關,與血Ca呈負相關(r =-0.394,P=0.005),而與血P無相關性(r=0.029,P=0.061);術後病理證實SMS患者甲狀徬腺組織增生以結節性增生為主。結論 SHPT閤併SMS的髮生主要與透析齡、血PTH、ALP、Ca及FGF-23水平相關。
목적:분석만성신쇠갈계발성갑상방선공능항진(SHPT)합병퇴축인종합정(SMS)환자적림상특점급상관성인소。방법선취재아원신내과주원병행갑상방선전절술적SHPT환자70례위연구대상,안신고교발병전시부축단분위퇴축조화비퇴축조,수집일반자료,소유환자균행갑상방선전절술,검측환자혈갑상방선격소(PTH)、혈린(P)、혈개(Ca)、감성린산매(ALP)、성섬유세포생장인자-23(FGF-23)수평,분석합병SMS적영향인소。결과70례SHPT환자중공유50례합병SMS,발생솔위71.4%;퇴축조환자투석령(t=8.368,P=0.000)、혈PTH(t=5.814,P=0.000)、혈P(t=3.470,P=0.001)、혈ALP(t=7.985,P=0.000)、혈FGF-23(t=2.128,P=0.037)수평명현고우비퇴축조;상관성분석표명,퇴축조환자신고축단여투석령(r=0.421,P=0.002)、PTH(r=0.418,P=0.003)、ALP(r=0.596, P=0.000)、FGF-23수평(r=0.875,P=0.000)균정정상관,여혈Ca정부상관(r =-0.394,P=0.005),이여혈P무상관성(r=0.029,P=0.061);술후병리증실SMS환자갑상방선조직증생이결절성증생위주。결론 SHPT합병SMS적발생주요여투석령、혈PTH、ALP、Ca급FGF-23수평상관。
Objective To analysis the clinical features and related affective factors of Shrinking man syndrome (SMS) in Secondary hyperparathyroidism (SHPT) patients. Methods Seventy SHPT patients were selected as research objects and all accepted parathyroidectomy. All of the patients were divided into shrinking group and control group according to whether their height shortened. The general information was collected, serum parathyroid hormone (PTH), phosphorus (P), calcium (Ca), alkaline phosphatase (ALP) and fibroblast growth factor-23 (FGF-23) detected, then analysis the affective factors of SMS. Results There were 50 patients with SHPT associated with SMS, the rate was 71.4%. Compared with control group, the dialysis ages (t=8.368, P=0.000), PTH (t=5.814, P=0.000), P (t=3.470, P=0.001), ALP (t=7.985, P=0.000), FGF-23 (t=2.128, P=0.037) in SMS group were significantly higher. The height shorten of SMS patients was positively correlated with dialysis ages (r=0.421, P=0.002), PTH (r=0.418, P=0.003), ALP (r=0.596, P=0.000) and FGF-23 (r=0.875, P=0.000), negatively correlated with serum Ca (r=-0.394, P=0.005), and the height shorten had no correlation with serum P (r=0.029, P=0.061). In addition, pathology analysis showed that in SMS patients the hyperplasia form of parathyroid glands was mostly nodular hyperplasia. Conclusion The affective factors of SMS in SHPT patients are dialysis ages, serum PTH, ALP, Ca and FGF-23.