摘要
目的探讨甲状旁腺切除术应用于继发性甲状旁腺功能亢进患者对其肾性贫血和营养状况的影响。方法选取2012年12月至2014年12月继发性甲状旁腺功能亢进患者73例，所有患者均为采用药物治疗无效后给予甲状旁腺切除术，观察所有患者手术前后血清甲状旁腺激素（iPTH）、Ca2＋、P3＋、钙磷乘积、血红蛋白（Hb）、血细胞比容（Hct）、重组人红细胞生成素（rHuEPO）用量、白蛋白（ALB）、总胆固醇（TC）、三酰甘油（TG）、体质量指数（BMI）、肱三头肌皮褶厚度（TSF）、上臂肌围、血清铁、铁蛋白、C-反应蛋白（CRP）、尿素清除指数（Kt／V）和尿素下降率（URR％）等指标情况。结果所有患者术后1、6、12个月血清iPTH、Ca2＋、P3＋、钙磷乘积水平均低于术前，差异有统计学意义（P〈0．05）；所有患者术后1、6、12个月Hb、Hct高于术前，差异有统计学意义（P〈0．05）；所有患者术后6、12个月rHuEPO用量低于术前，差异有统计学意义（P〈0．05）；所有患者术后6、12个月ALB水平高于术前，差异有统计学意义（P〈0．05）；所有患者术后12个月TG指标低于术前，BMI和TSF水平高于术前，差异有统计学意义（P〈0．05）；所有患者术后1、6、12个月血清铁、铁蛋白、CRP、Kt／V和URR％等指标与术前相比，差异未见统计学意义（P〉0．05）。结论甲状旁腺功能亢进是导致肾性贫血和营养不良的主要因素，甲状旁腺切除术应用于继发性甲状旁腺功能亢进患者可明显降低全段甲状旁腺激素水平，减轻患者肾性贫血症状，改善营养状况。
Objective To investigate the effect of parathyroid gland resection on renal anemia and nutritional status in patients with secondary parathyroid function. Methods From December 2012 to December 2014, 73 patients with secondary hyperthyroidism were treated with parathyroid gland resection after invalid drug therapy. The serum levels of iPTH, Ca2＋ , P, Hb, Hct, calcium and phosphorus prod- uct, the amount of rHuEPO, ALB, TC, TG, BMI, TSF, upper arm muscle circumference, serum iron, ferritin, CRP, Kt/V and URR% and other indicators before and after operation were observed. Results At 1 month, 6 months, 12 months after operation, the serum levels of iPTH, Ca2＋ , P, Ca and P were significantly lower than those before operation, and the differences were significant （ P 〈 0. 05 ） ; At 1 month, 6 months, 12 months after operation, the levels of Hot and Hb were significantly higher than those before operation, and the differences were significant （P 〈 0. 05 ） ; At 6 months and 12 months after operation, the amount of rHuEPO was significantly lower than that before operation （ P 〈 0.05 ） ; the ALB levels of all patients were significantly higher than those before operation at 6 months and 12 months after operation, and the differences were significant （ P 〈 0. 05 ） ; The TG indexes of all patients after 12 months of operation were lower than those before operation, and the differences were significant （P 〈 0. 05 ）, BMI and TSF levels were significantly higher than those before operation ; At 1 month, 6 months and 12 months after operation, there were no significant differences in the serum levels of iron, ferritin, CRP, Kt/V and URR% compared with those before operation （P 〉0. 05）. Conclusions Hyperpara-thyroidism is the leading cause of renal anemia and malnutrition and parathyroid gland resection in patients with secondary hyperparathyroidism, which can significantly reduce the intact parathyroid hormone levels, reduce the symptoms of renal anemia, and improve the nutritional status.
出处
《中国实用医刊》
2016年第23期35-38,共4页
Chinese Journal of Practical Medicine
