›› 2006, Vol. 5 ›› Issue (7): 358-360.

• 论著 • 上一篇    下一篇

血液透析患者甲状旁腺激素水平与营养的关系研究

陈国姿1 田锦鹰1 马祖等2 姜宗培3   

  1. 518001 1深圳,广东省深圳市罗湖区中医院肾内科(陈国姿曾于中山大学附属第一医院进修,就读中山大学医学院肾内科研究生进修班) 421001 2衡阳,南华大学第二附属医院肾内科 510089 3广州,中山大学附属第一医院肾内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2006-07-12 发布日期:2006-07-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2006-07-12 Published:2006-07-12

摘要: 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。

关键词: 甲状旁腺激素, 营养, 血液透析

Abstract: 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.

Key words: Nutrition, Hemodialysis

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