摘要
目的初步探讨严重产后出血并发急性肾损伤患者的甲状旁腺激素变化的临床意义。方法采用前瞻性研究,选取2014年6月-2016年6月该院严重产后出血并发急性肾损伤患者相关资料[年龄、总出血量、总去甲肾上腺素(NA)的用量、肌酐(Cr)、离子钙(i Ca^(2+))、离子磷(P)、急性生理与慢性健康(APACHEⅡ)评分及甲状旁腺激素(PTH)]进行统计学分析。结果共收集符合条件患者80例,分为并发急性肾损伤(AKI)Ⅰ级组患者23例,AKIⅡ级组患者34例,AKIⅢ级组患者23例,3组在入重症加强护理病房(ICU)时各项指标比较,其中,NA总用量、i Ca^(2+)和P比较,差异无统计学意义(P>0.05),而年龄、Cr、出血量、APACHEⅡ评分及PTH比较,差异有统计学意义(P=0.00)。3组治疗前后的Cr、APACHEⅡ评分、i Ca^(2+)、P和PTH比较,差异有统计学意义(P=0.00)。3组在好转后转出ICU时比较,Cr、APACHEⅡ评分和PTH比较差异有统计学意义(P<0.05),i Ca^(2+)和P差异无统计学意义(P>0.05)。PTH和Cr、APACHEⅡ评分呈正相关,与i Ca^(2+)无相关。结论甲状旁腺激素在严重产后出血的急性肾损伤患者中的变化与病情严重程度有关,和i Ca^(2+)关系不大。
Objective To investigate clinical significance of parathyroid hormone changes in patients with severe postpartum hemorrhage complicated with acute kidney injury（AKI）. Methods Aretrospective study was performed on patients with severe postpartum hemorrhage complicated with AKI admitted into the first affiliated hospital of Bengbu medical college from June 2014 to June 2016. Age, total blood loss, total norepinephrine（NA）, creatinine（Cr）, calcium ion（i Ca^2＋）, ionic phosphorus（P）, score and parathyroid hormone（PTH） were recorded. Results Totally 80 cases were identified, among which 23 cases had grade Ⅰ AKI, 34 patients had grade Ⅱ AKI and 23 patients hadgrade Ⅲ AKI. No significant differences in total amount of NA, i Ca^2＋ and P were founded among the 3 groups（P〈0.05）. Age, Cr, total blood loss, APACHE Ⅱ score, and PTH were differentially distributed among the 3 groups（P = 0.00）. Standard treatment ameliorated dramatically clinical index of Creatinine, APACHE Ⅱ score, i Ca^2＋, P and PTH compared withthose prior to any treatments（P = 0.00）. Statistically significant differences in creatinine, APACHE Ⅱ score and PTH（P〉0.05） but not with i Ca^2＋ and P（P〉0.05） were identified. Correlation analysis indicated a linear positive correlation between PTH and creatinine or APACHE Ⅱ score but no obvious correlation was identified between PTH and i Ca^2＋. Conclusions Parathyroid hormone is correlated to the severity of disease in patients with severe postpartum hemorrhage complicated with AKI.
作者
刘成
邹琪
赵飞
Cheng Liu;Qi Zou;Fei Zhao(Department of Critical Care Medicine, the First Afliated Hospital of Bengbu Medical College, Bengbu, Anhui 233000, Chin)
出处
《中国现代医学杂志》
CAS
2018年第15期54-58,共5页
China Journal of Modern Medicine
基金
2015年安徽公益性技术应用研究联动计划项目(No:1501ld04052)
