CAJ | 학술논문

目的：探讨甲状旁腺素（PTH）与尿毒症皮肤瘙痒的时相关系。方法用双抗体放射免疫法检测患者PTH，用DirkR．Kuypers方法对尿毒症瘙痒进行评分。对不同透析时期尿毒症患者PTH和皮肤瘙痒的发病率关系进行研究，并对尿毒症皮肤瘙痒用西那卡塞治疗后的PTH、钙磷乘积和瘙痒程度相应改变进行相关分析。结果皮肤瘙痒组PTH较无瘙痒组明显升高（P＜0．01）。PTH和皮肤瘙痒的发病率均随时间的延长而升高，其中3～6个月组PTH较小于3个月组PTH明显升高，9～12个月组瘙痒率较小于3个月组明显增高，差异有统计学意义（P＜0．01）。PTH水平和瘙痒率呈正相关（r＝0．653）。西那卡塞治疗后患者瘙痒程度评分、钙磷乘积和PTH都随治疗时间的延长而下降。治疗1个月后与治疗前比较，钙磷乘积和PTH均明显下降（P＜0．01），治疗第3个月显示瘙痒程度明显下降（P＜0．01）。瘙痒程度和钙磷乘积、瘙痒程度和PTH以及PTH和钙磷乘积的相关系数分别为0．642、0．835和0．707（P＜0．01）。结论西那卡塞能明显降低透析患者PTH和钙磷乘积，同时能缓解尿毒症皮肤瘙痒。
목적：탐토갑상방선소（PTH）여뇨독증피부소양적시상관계。방법용쌍항체방사면역법검측환자PTH，용DirkR．Kuypers방법대뇨독증소양진행평분。대불동투석시기뇨독증환자PTH화피부소양적발병솔관계진행연구，병대뇨독증피부소양용서나잡새치료후적PTH、개린승적화소양정도상응개변진행상관분석。결과피부소양조PTH교무소양조명현승고（P＜0．01）。PTH화피부소양적발병솔균수시간적연장이승고，기중3～6개월조PTH교소우3개월조PTH명현승고，9～12개월조소양솔교소우3개월조명현증고，차이유통계학의의（P＜0．01）。PTH수평화소양솔정정상관（r＝0．653）。서나잡새치료후환자소양정도평분、개린승적화PTH도수치료시간적연장이하강。치료1개월후여치료전비교，개린승적화PTH균명현하강（P＜0．01），치료제3개월현시소양정도명현하강（P＜0．01）。소양정도화개린승적、소양정도화PTH이급PTH화개린승적적상관계수분별위0．642、0．835화0．707（P＜0．01）。결론서나잡새능명현강저투석환자PTH화개린승적，동시능완해뇨독증피부소양。
Objective To study the correlation between uremic pruritus and levels of parathyroid hormone (PTH) .Methods PTH was detected by double antibody radioimmunoassay .Uremic pruritus was scored by Dirk R . Kuypers method .Correlation between levels of PTH and incidence rate of uremic pruritus in patients with uremia at different stages of hemodialytic treatment was analyzed ,and the influence of Cinacalcet treatment on levels of PTH , calcium-phosphate concentration and pruritus was also analyzed .Results Level of PTH in pruritus group was signif-icantly higher than non-prutitus group (P<0 .01) .Level of PTH and incidence rate of pruritus increased with the prolonging of course of disease .Level of PTH in patients receiving dialysis of 3-6 months was significantly higher than patients receiving dialysis of less than 3 months (P<0 .01) ,and the incidence rate of uremic pruritus in patients receiving dialysis of 9-12 months was significantly higher than patients receiving dialysis of less than 3 months (P<0 .01) .PTH level was positively correlated with the incidence rate of uremic pruritus (r=0 .653) .The score of ure-mic pruritus ,calcium-phosphate product and PT H level decreased after Cinacalcet treatment . Calcium-phosphate product and PTH level detected 1 month after treatment were significantly decreased ,compared with results detected before treatment (P<0 .05 or 0 .01) .However ,the score of uremic pruritus significantly decreased after 3 months of treatment (P<0 .01) .The correlation coefficients of pruritus and calcium-phosphate product ,pruritus and PTH ,and PTH and calcium-phosphate product were respectively 0 .642 ,0 .835 and 0 .707 (P<0 .01) .Conclusion Cinacalcet treatment could significantly reduce levels of PT H and calcium-phosphate product ,and could also alleviate uremic pruritus .