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甲状旁腺机能亢进是慢性肾衰贫血的发病机制之一。循环中PTH过多可能会直接抑制红细胞生成,也可能通过导致骨髓纤维化而间接引起贫血。成功的肾移植后,血清肌酐和红细胞生成素会很快恢复正常,但血清PTH升高会持续很长时间。此项研究的目的就是评价术前存在的继发性甲状旁腺机能亢进对成功的肾移植后贫血恢复的影响。研究对象为45例肾移植后肾功正常的病人。所有患者均无失血情况,也未接受输血和铁剂治疗。根据移植时血清PTH水平将病人分为两组:A组23例病人血清PTH水平正常;B组22例为甲状旁腺机能亢进的病人。所有病人于术前及术后一周、一个月、三个月和六个月检查血清肌酐、血球压积、血红蛋白、血清铝、铁蛋白和血清PTH。研究结果表明,尽管B组血清PHT水平在术后呈下降趋势,但在术后6个月时仍高于正常值。B组患者贫血的恢复明显慢于A组,表现在术后6个月时B组的
Hyperparathyroidism is one of the pathogenesis of anemia in chronic renal failure. Too much PTH in the circulation may directly inhibit erythropoiesis and may indirectly cause anemia by causing myelofibrosis. After successful kidney transplantation, serum creatinine and erythropoietin will quickly return to normal, but elevated serum PTH will last a long time. The purpose of this study was to evaluate the effect of preoperative preoperative hyperparathyroidism on the success of anemia after renal transplantation. The object of study was 45 patients with normal kidney function after kidney transplantation. All patients had no blood loss and had no blood transfusion or iron therapy. The patients were divided into two groups according to serum PTH level at transplantation: serum PTH levels of 23 patients in group A were normal; in group B, 22 patients were patients with hyperparathyroidism. Serum creatinine, hematocrit, hemoglobin, serum aluminum, ferritin, and serum PTH were examined in all patients one week, one month, three months and six months after surgery. The results showed that, although serum PHT levels in group B decreased after surgery, but still higher than normal after 6 months. The recovery of anemia in group B was significantly slower than that in group A, which was manifested in group B at 6 months after operation