目的 探讨血液透析患者甲状旁腺素与营养状况的关系，为提高患者透析充分而改善患者营养状况提供临床依据。 方法 ①选择中山大学附属第一医院肾内科112例血液透析患者，测定患者透析前血清甲状旁腺(PTH)、血清白蛋白(ALB)、血红蛋白(Hb)、C-反应蛋(CRP)、转铁蛋白(TF)；②人体指数学测量：肱二头肌皮褶(BSF)、肱三头肌皮褶(TSF)、上臂中部周径(MAC)、握力(HGS)；③使用改良整体主观评估法(modified quantitative subjective global assessment, MQSGA)评估患者营养状况；④测定患者透析前血清IGF-1、IGFBP3；⑤根据相关公式计算上臂中部肌肉周径(MAMC)、上臂中部肌肉面积(AMA)；⑥统计分析PTH与各营养指标之间的直线相关和回归关系。结果 PTH与MQSGA呈正相关(P＜0.01)，与ALB、MAC、MAMC、AMA 呈负相关(P＜0.05)，与Hb呈显著负相关(P＜0.001)；PTH与 MQSGA、Hb、MAMC、AMA之间存在回归关系（P＜0.05）。结论 PTH是影响血液透析患者营养状况的重要尿毒症毒素。

Objective To study the relationship between parathyroid hormone（PTH） and nutritional status of patients in maintenance hemodialysis. Methods ①serum PTH, ALB, Hb , C-reactive protein, transferrin were examined；② anthropometric indices including biceps skin fold(BSF), triceps skin fold(TSF) and mid arm circumference (MAC) were measured； ③nutritional status of the patients were evaluated with modified quantitative subjective global assessment (MQSGA)； ④insulin-like growth factor-1 (IGF-1) and insulin-like growth factor blnding protein-3 (IGFBP-3) were assessed； ⑤ mid arm muscle circumference(MAMC) and bone-free arm muscle area(AMA) were calculated according to its formula； ⑥the relationship between PTH and nutritional status were analysed. Results There were positive correlation between PTH and MQSGA(P＜0.01) and negative correlations between PTH and ALB, MAC, MAMC, AMA(P＜0.05). A significant negative correlation was found between PTH and Hb(P＜0.01). There were regression relations between PTH and MQSGA, Hb, MAMC, AMA (P＜0.05). Conclusion PTH can impact nutritional status of hemodialysis patients.