CAJ | 학술논문

目的：探讨甲状旁腺素（PTH）水平与尿毒症患者贫血及心血管疾病（CVD）危险因素的相关性。方法：收集91例首次就诊住院的尿毒症（CKD5期）患者，按血iPTH水平将患者分为甲状旁腺功能亢进组和非亢进组，比较两组的临床资料。结果：继发性甲状旁腺功能亢进（SHPT）的患病率为40．66％，与非亢进组相比，亢进组患者的平均年龄较轻，贫血较重，血钙、甘油三酯、空腹血糖和超敏C反应蛋白水平较低，血磷和血肌酐水平较高，残余肾功能较差，两组间有显著性差异（P＜0．05）。相关性分析显示血iPTH水平与年龄、血红蛋白、肌酐清除率、甘油三酯、血钙水平呈负相关（P＜0．05），与血肌酐和血磷水平呈正相关（P＜0．05）。结论：低血钙、高血磷、低肾小球滤过率是SHPT发生的危险因素，SHPT会加剧肾性贫血，PTH与其他CVD危险因素间的相关性不明显，提示其通过直接作用于心血管系统而增加CVD风险。
목적：탐토갑상방선소（PTH）수평여뇨독증환자빈혈급심혈관질병（CVD）위험인소적상관성。방법：수집91례수차취진주원적뇨독증（CKD5기）환자，안혈iPTH수평장환자분위갑상방선공능항진조화비항진조，비교량조적림상자료。결과：계발성갑상방선공능항진（SHPT）적환병솔위40．66％，여비항진조상비，항진조환자적평균년령교경，빈혈교중，혈개、감유삼지、공복혈당화초민C반응단백수평교저，혈린화혈기항수평교고，잔여신공능교차，량조간유현저성차이（P＜0．05）。상관성분석현시혈iPTH수평여년령、혈홍단백、기항청제솔、감유삼지、혈개수평정부상관（P＜0．05），여혈기항화혈린수평정정상관（P＜0．05）。결론：저혈개、고혈린、저신소구려과솔시SHPT발생적위험인소，SHPT회가극신성빈혈，PTH여기타CVD위험인소간적상관성불명현，제시기통과직접작용우심혈관계통이증가CVD풍험。
Objective:To elevate the association between parathyroid hormone level and anemia , risk factors of cardiovascular disease in uremic patients. Methods: Medical records of 91 resident patients who were diagnosed as uremia (CKD 5 stage) for the first time were reviewed and classified into SHPT group and non-SHPT group according to the intact parathyroid hormone (iPTH) level. We then examined clinical features between the two groups. Results:The prevalence of SHPT was 40.66%. It revealed significantly younger age, lower level of hemoglobin, calcium, triglyceride, fasting blood glucose, hs-CRP and GFR, higher level of phosphorus and creatinine in SHPT group (P<0.05). Correlation analysis showed that serum iPTH level was negatively correlated with age, hemoglobin, GFR, serum triglyceride and calcium level (P<0.05), but positively correlated with serum creatinine and phosphorus level (P<0.05). Conclusions: Hypocalcemia, hyperphosphatemia, lower GFR were risk factors of SHPT. Renal anemia was worsened by SHPT. The correlation between PTH and other risk factors of CVD were not obvious. It supported that PTH effected on the cardiovascular system directly to increase the risk of CVD.