中国血液净化

中国血液净化 ›› 2014, Vol. 13 ›› Issue (06): 462-465.doi: 10.3969/j.issn.1671-4091.2014.06.011

• 临床研究 • 上一篇    下一篇

甲状旁腺切除对继发性甲状旁腺功能亢进症患者左心室肥厚的影响

刘东1,魏学明2,高卓1,李新伦1,胡瑞海1,李红霞1,缪静1,伦立德1   

  1. 1. 空军总医院肾病科
    2. 空军总医院普通外科
  • 收稿日期:2014-01-26 修回日期:2014-03-26 出版日期:2014-06-12 发布日期:2014-06-12
  • 通讯作者: 伦立德 lunlideldm@163.com E-mail:lunlideldm@163.com
  • 基金资助:

    北京首都临床特色应用研究基金(Z111107058811085)资助

Effects of a parathyroidectomy on left ventricular hypertrophy of uremic patients with secondary hyperparathyroidism.

  • Received:2014-01-26 Revised:2014-03-26 Online:2014-06-12 Published:2014-06-12

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摘要： 【摘要】目的 观察甲状旁腺切除对尿毒症继发性甲状旁腺功能亢进症（SHPT）患者左心室肥厚的影响。方法 选取21例SHPT患者，分为手术组13例和常规治疗组8例，手术组切除甲状旁腺，于手术前及手术1年后分别化验血清钙（Ca）、血清磷（P）、血清全段甲状旁腺激素（iPTH）,进行心脏超声检查，测量左室舒张末期内径(LVED)，室间隔厚度(IVST)、左室后壁厚度(LVPWT)，左心室射血分数（LVEF）计算左心室重量指数(LVMI)。结果 手术1年后，手术组患者血清Ca、P、Ca×P、iPTH水平均较术前明显降低 (t= -3.823、-3.873、-4.531、-10.545，均P <0.01)，LVMI由153.7±56.7g/m2下降到119.5±29.4 g/m2，手术治疗对LVMI、IVST、LVPWT的影响具有统计学意义（F=4.180、4.174、5.959，P=0.048、0.048、0.019），对LVED、LVEF的影响无统计学差异（F=2.662、1.010, P=0.111、0.377）。结论 甲状旁腺切除能有效改善尿毒症继发甲状旁腺功能亢进症患者的左心室肥厚。

关键词: 尿毒症, 继发性甲状旁腺功能亢进, 甲状旁腺切除术, 左心室肥厚

Abstract: 【Abstract】Objective To observe the effect of parathyroidectomy on left ventricular hypertrophy of uremic patients with secondary hyperparathyroidism(SHPT). Methods 21 SHPT patients were divided into two groups. 13 patients received parathyroidectomy; 8 patients received regular treatment. Before and 1 year after parathyroidectomy, the serum calcium(Ca), phosphorus(P), parathyroid(iPTH), left ventricular end diastolic diamete(LVED)、interventricular septum diastolic thickness (IVST)，left ventricular posterior wall diastolic thickness(LVPWT), left ventricular ejection fraction (LVEF)were measured, LVMI were calculated. Results The levels of Ca、P、Ca×P、iPTH were decreased after parathyroidectomy(t= -3.823、-3.873、-4.531、-10.545，P <0.01, respectively).The levels of LVMI were decreased from 153.7±56.7g/m2 to 119.5±29.4 g/m2. The effects of parathyroidectomy to LVMI、IVST、LVPWT were signifant (F=4.180、4.174、5.959，P=0.048、0.048、0.019). Conclusion Parathyroidectomy could improve left ventricular hypertrophy of uremic patients with secondary hyperparathyroidism.

Key words: Uremia, Secondary hyperparathyroidism, Parathyroidectomy, left ventricular hypertrophy