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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i PTH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i PTH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。
Objective: To investigate the relationship between parathyroid hormone (PTH) level and risk factors of anemia and cardiovascular disease (CVD) in patients with uremia. Methods: Totally 91 patients with uremia (CKD stage 5) who were hospitalized for the first time were enrolled. Patients were divided into hyperparathyroidism group and non-hypertensive group according to the i PTH level. The clinical data of the two groups were compared. Results: The prevalence of secondary hyperparathyroidism (SHPT) was 40.66%. Compared with non-hyperthyroidism group, the average age of hyperthyroidism group was mild, the anemia was severe, serum calcium, triglyceride, fasting blood glucose And high-sensitivity C-reactive protein were lower, serum phosphorus and serum creatinine levels were higher, and residual renal function was poor. There was a significant difference between the two groups (P <0.05). Correlation analysis showed that serum i PTH level was negatively correlated with age, hemoglobin, creatinine clearance, triglyceride and serum calcium levels (P <0.05), and positively correlated with serum creatinine and serum phosphorus (P <0.05). Conclusion: Hypocalcemia, hyperphosphatemia and glomerular filtration rate are the risk factors of SHPT. SHPT can aggravate renal anemia. The correlation between PTH and other risk factors of CVD is insignificant, suggesting that it is directly related to Cardiovascular system and increase the risk of CVD.