中国血液净化

›› 2005, Vol. 4 ›› Issue (8): 420-423.

• 论著 • 上一篇    下一篇

1,25(OH)2D3抑制甲状旁腺激素对维持性血液透析患者残余肾功能的影响

郭云珊 袁伟杰 刘明媛 崔若兰   

  1. 200433 上海，上海第二医科大学附属长海医院肾内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2005-08-12 发布日期:2005-08-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2005-08-12 Published:2005-08-12

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摘要： 目的 探讨1,25(OH)2D3通过降低血液透析患者甲状旁腺激素(PTH)水平对其残余肾功能 (RRF)的影响及影响机制。方法 回顾性分析第二军医大学长海医院2001年4月～2003年3月160例慢性肾衰竭维持性血液透析患者服用1,25(OH)2D3前后PTH及其同期肾小球滤过率(GFR)、收缩压(SBP)、舒张压(DBP)、钙(Ca)、磷(P)、钙磷乘积(Ca×P)、三酰甘油(TG)、胆固醇(CH)、左心室心肌重量指数(LVMI)之间的相关关系。结果 160例患者中63.6％存在继发性甲状旁腺功能亢进症(SHPT)。高PTH血症患者较非高PTH血症患者GFR明显下降（P＜0.05）。PTH与SBP、DBP、Ca×P、AKP、TG、LVMI 呈正相关，与Ca、GFR、KT/V呈负相关；GFR与KT/V呈正相关，与SBP、DBP、TG、CH、P、Ca×P、LVMI 呈负相关。服用1,25(OH)2D3组较未服用1,25(OH) 2D3组PTH、SBP、DBP、AKP、P、Ca×P、TG、CH、LVMI(P＜0.05)水平降低，Ca、GFR(P＜0.05)水平升高。结论 维持性血液透析患者常伴PTH升高，PTH可能是导致残余肾功能下降的重要因素。1,25(OH)2D3可通过降低维持性血液透析患者的PTH、血压、血脂等保护并改善肾功能。

关键词: 血液透析, 残余肾功能, 甲状旁腺激素, 25(OH) 2D3

Abstract: Objective To investigate the effect of Calcitriolum on the influence of parathy-roid (PTH) on residual renal function(RRF). Methods We analyzed the relationship between hormone PTH and calcium(Ca),phosphorus(P)，calcium-phosphorus product (Ca×P), hypertension, triglyceride(TG), cholesterol(CH), left ventricular mass index (LVMI) and glomerular filtration rate (GFR) in 160 hemodialysis patients with chronic renal failure with or without calcitriolum. Results The results showed that 63.6% of the hemodialysis patients with chronic renal failure had secondary hyperparathyroidism(SHPT). We found that PTH had positive correlation with systolic blood pressure (SBP), diastolic blood pressure (DBP), Ca×P, TG and LVMI, and had negative correlation with Ca, GFR, KT/V. GFR had positive correlation with KT/V, and negatire correlation with SBP, DBP, P, Ca×P, TG, CH and LVMI. The levels of PTH, SBP, DBP, P, Ca×P, TG, CH, LVMI were lower and the levels of Ca, GFR were higher in the patients who received Calcitriolum than in the subjects without Calcitriolum. Conclusion Hemodialysisi patients of ten have a high PTH level which could contribute to RRF loss. Calcitriolum can slow down the deterioration of RRF.

Key words: Residual renal function, Parathyroid hormone, Calcitriolum.

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