临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
Journal of Clinical and Experimental Medicine
2015年
20期
1716-1719
,共4页
尿毒症%甲状旁腺功能亢进症%高通量血液透析%甲状旁腺素%钙磷代谢
尿毒癥%甲狀徬腺功能亢進癥%高通量血液透析%甲狀徬腺素%鈣燐代謝
뇨독증%갑상방선공능항진증%고통량혈액투석%갑상방선소%개린대사
Uremia%Secondary Hyperparathyroidism%High throughput hematodialysis%Parathyroid hormone%Calcium - phosphorus Me-tabolism
目的：探讨高通量血液透析对尿毒症合并继发性甲状旁腺功能亢进（SHPT）患者的甲状旁腺激素和钙磷代谢的影响。方法选取2012年1月值2014年12月在大连医科大学附属第二医院行血液透析的尿毒症合并 SHPT 患者70例为研究对象，将患者随机分为 A 组和 B 组，各35例。A 组和 B 组患者分别给予高通量和低通量血液透析。比较两组患者透析前及透析后第6、12个月的甲状旁腺激素（iPTH）、血钙、血磷、碱性磷酸酶（AKP）、骨型碱性磷酸酶水平（骨型 AKP）、透析充分性指标；计算并比较其生存率，进行相关性分析与 Logistic 回归分析。结果 A 组和 B 组的 iPTH、骨型 AKP、血磷与透析时间存在交互作用；两组血磷、iPTH、骨型 AKP 水平比较，差异有统计学意义（ P ﹤0.05）。两组透析后6、12个月血磷、iPTH、骨型 AKP 水平比较，差异均有统计学意义（ P ﹤0.05）。血磷、iPTH、骨型 AKP 水平不同时
目的：探討高通量血液透析對尿毒癥閤併繼髮性甲狀徬腺功能亢進（SHPT）患者的甲狀徬腺激素和鈣燐代謝的影響。方法選取2012年1月值2014年12月在大連醫科大學附屬第二醫院行血液透析的尿毒癥閤併 SHPT 患者70例為研究對象，將患者隨機分為 A 組和 B 組，各35例。A 組和 B 組患者分彆給予高通量和低通量血液透析。比較兩組患者透析前及透析後第6、12箇月的甲狀徬腺激素（iPTH）、血鈣、血燐、堿性燐痠酶（AKP）、骨型堿性燐痠酶水平（骨型 AKP）、透析充分性指標；計算併比較其生存率，進行相關性分析與 Logistic 迴歸分析。結果 A 組和 B 組的 iPTH、骨型 AKP、血燐與透析時間存在交互作用；兩組血燐、iPTH、骨型 AKP 水平比較，差異有統計學意義（ P ﹤0.05）。兩組透析後6、12箇月血燐、iPTH、骨型 AKP 水平比較，差異均有統計學意義（ P ﹤0.05）。血燐、iPTH、骨型 AKP 水平不同時
목적：탐토고통량혈액투석대뇨독증합병계발성갑상방선공능항진（SHPT）환자적갑상방선격소화개린대사적영향。방법선취2012년1월치2014년12월재대련의과대학부속제이의원행혈액투석적뇨독증합병 SHPT 환자70례위연구대상，장환자수궤분위 A 조화 B 조，각35례。A 조화 B 조환자분별급여고통량화저통량혈액투석。비교량조환자투석전급투석후제6、12개월적갑상방선격소（iPTH）、혈개、혈린、감성린산매（AKP）、골형감성린산매수평（골형 AKP）、투석충분성지표；계산병비교기생존솔，진행상관성분석여 Logistic 회귀분석。결과 A 조화 B 조적 iPTH、골형 AKP、혈린여투석시간존재교호작용；량조혈린、iPTH、골형 AKP 수평비교，차이유통계학의의（ P ﹤0.05）。량조투석후6、12개월혈린、iPTH、골형 AKP 수평비교，차이균유통계학의의（ P ﹤0.05）。혈린、iPTH、골형 AKP 수평불동시
Objective To investigate the clinical effect of high flux hemodialysis in the treatment of patients with uremia associated with secondary hyperparathyroidism(SHPT). Methods A total of 40 patients who were on dialysis in Dalian Medical University from January 2012 to December 2014 and met inclusion and exclusion criteria were selected and randomly divided into group A(n = 35)and group B(n = 35). Group A was treated with high flux dialysis,and group B was treated with low flux dialysis. The blood calcium,blood phosphorus,intact parathy-roid hormone(iPTH),alkline phosphatase(AKP),bone - type alkaline phosphatase,parameters for dialysis adequacy and survival rate of the two groups were compared before dialysis,6 months,12 months after dialysis. Correlation analysis and Logistic regression analysis were also per-formed. Results The dialysis time had interactive effect on blood phosphorus,iPTH and bone - type alkaline phosphatase( P ﹤ 0. 05). The two groups showed significant differences in blood phosphorus,iPTH and bone - type alkaline phosphatase( P ﹤ 0. 05). The two groups also showed significant differences in blood phosphorus,iPTH and bone - type alkaline phosphatase,6 months,and 12 months after dialysis( P ﹤ 0. 05). The blood phosphorus,iPTH and bone - type alkaline phosphatase at different time showed significant differences( P ﹤ 0. 05). The dialysis time had no interactive effect on KT/ V and URR( P ﹥ 0. 05). The survival rate in group A and group B was 88. 5%( 31 / 35)and 71. 4%( 25 /35),respectively,and the difference was significant(χ2 = 6. 52,P = 0. 03). Conclusion High flux hemodialysis can reduce iPTH level and improve metabolic disorders of calcium and phosphorus for patients with uremia associated with SHPT.
