摘要
目的探讨血清全段甲状旁腺激素(iPTH)、钙(Ca2+)、磷(P)浓度对肾脏疾病的辅助诊断价值。方法检测231例慢性肾炎综合征患者、106例肾病综合征患者、422例慢性肾功能不全患者(分为4期)和54名正常人(对照组)血清iPTH、Ca2+、P水平。结果血清iPTH、Ca2+、P浓度在慢性肾炎综合征组分别为37.02(26.61,51.33)pg/ml、(2.16±0.15)mmol/L、(1.25±0.27)mmol/L,肾病综合征组分别为29.08(22.65,42.63)pg/ml、(2.00±0.19)mmol/L、(1.27±0.24)mmol/L,对照组分别为38.78(32.39,51.19)pg/ml、(2.32±0.83)mmol/L、(1.16±0.15)mmol/L;血清Ca浓度在慢性肾功能不全4期分别为(2.24±0.13)mmol/L、(2.09±0.18)mmol/L、(2.05±0.17)mmol/L、(2.01±0.30)mmol/L,血清iPTH、P浓度慢性肾功能不全失代偿期组111.15(75.05,151.50)pg/ml、(1.40±0.31)mmol/L,肾功能衰竭期组187.10(130.20,285.93)pg/ml、(1.64±0.3)4mmol/L,尿毒症期组269.45(158.70,416.33)pg/ml、(2.09±0.53)mmol/L,与对照组差异有统计学意义(P<0.01),随着肾功能进一步损害,iPTH、P水平进一步升高(P<0.01);各肾脏病组血清Ca2+浓度与对照组差异有统计学意义(P<0.01);慢性肾功能不全失代偿期组、肾功能衰竭期组和尿毒症期组血清iPTH与Ca2+呈明显负相关;肾功能衰竭期组和尿毒症期组血清iPTH与P呈明显正相关。结论血清iPTH联合Ca2+、P检测可作为肾功能失代偿的预警指示之一,对临床不同类型肾脏疾病的早期诊断和治疗具有指导意义。
Objective To study the serum levels of intact parathyroid hormone （iPTH）, calcium （Ca^2＋）and phosphorus （P） in accessory diagnosis of kidney disease. Methods Serum levels of iPTH, Ca^2＋ and P in 231 patients with chronic nephritic syndrome, 106 patients with nephritic syndrome, 422 patients with chronic renal insufficiency （CRI）, and 54 normal subjects who served as controls were measured with Cobas601 and Cobas701 automatic analyzers. Results The serum levels of iPTH, Ca^2± and P were 37.02（26.61,51.33） pg/ml, （2.16±0.15）mmol/L and （1.25 ± 0.27）mmol/L respectively in patients with chronic nephritic syndrome, 29.08（22.65, 42.63） pg/ml, （2.00 ± 0.19）mmol/L and （1.27 ± 0.24）mmol/L respectively in those with nephrotic syndrome, 38.78（32.39, 51.19）pg/ml, （2.32 ± 0.83）mmol/L and （1.16 ± 0.15）mmol/L respectively in controls. The serum Ca2± level was （2.24 ± 0.13）mmol/L, （2.09 ± 0.18 ）mmol/L, （2.05 ± 0.17）mmol/L and （2.01 ± 0.30）mmol/L respectively in 4 stages of CRI. No significant difference was found in serum levels of iPTH and P between those at de-compensation stage [ 111.15（75.05, 151.50）pg/ml, （1.40 ± 0.31）mmol/L], renal failure stage [ 187.10（ 130.20,285.93）pg/ml, （ 1.64 ± 0.34）mmol/L], uremia stage [269.45 （ 158.70, 416.33）pg/ml, （2.09 ± 0.53）retool/L] and controls （P〈0.01）. However, the serum levels of iPTH and P increased with the severity of renal dysfunction. The serum Ca^2＋ level was significantly higher in patients with kidney disease than in controls （P〈0.01）. The serum iPTH level was negatively related with the serum Ca^2＋ level in patients at de-compensation stage, renal failure stage and uremia stage, and positively related with the serum levels of iPTH and P in those at renal failure stage and uremia stage. Conclusion Serum levels of iPTH, Ca^2＋ and P can be used as one of the warning factors for renal dysfunction and contribute to the early diagnosis and treatment of different types of renal disease.
出处
《军医进修学院学报》
CAS
2012年第9期913-915,949,共4页
Academic Journal of Pla Postgraduate Medical School
基金
解放军总医院博士研究生创新性科研项目(10BCZ01)
关键词
全段甲状旁腺激素
钙
磷
肾脏疾病
intact parathyroid hormone
calcium
phosphorus
kidney disease
