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目的探讨慢性肾衰竭(CRF)维持性血液透析患者血清甲状旁腺激素(PTH)与机体营养的关系。方法运用随机抽样的方法选取2013年1-12月台州市立医院血透室收治的112例CRF维持性血液透析患者作为研究对象,依据患者的营养状况将患者分为营养良好组(A组,40例)、轻中度营养不良组(B组,40例)、重度营养不良组(C组,32例),用放射免疫法对全段PTH(i PTH)进行测定,用溴甲酚绿测定白蛋白(ALB),用免疫速率法测定C-反应蛋白(CRP)、转铁蛋白(TF),用全自动血液细胞分析仪测定血红蛋白(Hb),自动生化分析仪测定尿素氮(BUN)、血肌酐(SCr),然后对3组患者生化指标、PTH与各营养指标的相关性进行统计分析。结果 3组患者的体质指数(BMI)、SCr、CRP水平的差异均有统计学意义(P<0.05),但BUN、TF水平的差异均无统计学意义(P>0.05);A组、B组患者的肱三头肌皮褶厚度(TSF)、上臂中段肌肉周径(MAMC)均明显高于C组,A组患者的PTH明显低于C组,Hb、ALB均明显高于C组,差异均有统计学意义(P<0.05);PTH与BMI、TSF、MAMC、ALB、Hb和SCr均呈负相关(P<0.05),与CRP呈正相关(P<0.05),但和TF、BUN无相关性(P>0.05)。结论 CRF维持性血透患者PTH与机体营养呈负相关,值得临床重视。
Objective To investigate the relationship between serum parathyroid hormone (PTH) and body nutrition in maintenance hemodialysis patients with chronic renal failure (CRF). Methods A total of 112 CRF hemodialysis patients admitted to the Hemodialysis Hospital of Taizhou City Hospital from January to December in 2013 were selected as the research objects. According to the nutritional status of the patients, the patients were divided into two groups: group A (n = 40) (Group B, 40 cases) and severe malnutrition group (group C, 32 cases). The radioimmunoassay was used to determine the PTH (i PTH) of the whole segment. Serum albumin (ALB), C-reactive protein (CRP) and transferrin (TF) were measured by the immunosorbent assay, hemoglobin (Hb) was measured by automatic hematology analyzer, urea nitrogen (BUN) Serum creatinine (SCr), and then the three groups of biochemical indicators, PTH and nutritional indicators for statistical analysis. Results There were significant differences in BMI, SCr and CRP levels between the three groups (P <0.05), but there was no significant difference between BUN and TF (P> 0.05) The TSF and MAMC in group A were significantly higher than those in group C, the PTH in group A was significantly lower than that in group C, and the levels of Hb and ALB in group A were significantly higher than those in group C PTH was negatively correlated with BMI, TSF, MAMC, ALB, Hb and SCr (P <0.05), but positively correlated with CRP (P <0.05) No correlation (P> 0.05). Conclusion There is a negative correlation between PTH and body nutrition in CRF maintenance hemodialysis patients, which deserves clinical attention.