腹膜透析患者的低甲状旁腺激素血症与营养状态的关系

韩庆烽; 孙玲华

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中国血液净化 ›› 2006, Vol. 5 ›› Issue (7) : 361-362.

论著

腹膜透析患者的低甲状旁腺激素血症与营养状态的关系

韩庆烽孙玲华

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摘要

目的调查腹膜透析患者中低甲状旁腺激素血症的发病情况，以及可能与之相关的因素。方法回顾性研究北京大学第三医院肾内科66例腹膜透析患者，每3个月测定血清iPTH水平，当血清iPTH水平高于300 ng/L时使用活性维生素D治疗，并每月测定血清iPTH。同时测定血清白蛋白水平，使用SGA评估患者的营养状况。结果有32%的患者存在持续性低PTH血症，有42%的患者出现暂时性低PTH血症。持续性低PTH血症组患者血清白蛋白水平明显低于暂时性低PTH血症(P=0.024)，营养不良的发生率也明显升高(P=0.020)。结论腹膜透析患者中低PTH血症发生率较高，且与营养不良的发生存在一定的关系。对于营养不良的透析患者在使用活性维生素D时应高度注意导致低PTH血症的可能。

Abstract

Objective To investigate the prevalence of hypoparathyroidism in peritoneal dialysis patients (PD) and the possible factors related to hypoparathyroidism. Methods Sixty-six peritoneal dialysis patients were involved in this retrospective study. Serum intact parathyroid hormone (iPTH) were detected every 3 months after dialysis, when it exceeded 300 ng/L, calcitriol were administered and iPTH then were rechecked every month. Serum albumin and subjective global assessment (SGA) were used to evaluate the nutritional status. Results Of all patients, 32% patients had permanent hypoparathyroidism, and 42% had temporal hypoparathyroidism. Serum albumin level was lower in permanent hypoparathyroidism group than temporal group (P = 0.024), and higher malnutrition rate also could be found in this group (P=0.020). Conclusion Hypoparathyroidism was frequent in PD patients, and it was related to malnutrition. To PD patients with malnutrition, more attention must be paid in the use of calcitriol.