甲状旁腺素及骨转运指标的测定在维持性血液透析患者肾性骨病诊断中的意义被引量：21

Parathyroid Hormone and Bone Turnover Markers for Diagnosis of Renal Osteodystrophy in Maintenance Hemodialysis Patients

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摘要目的本研究通过对维持性血液透析(maintenance hemodialysis,MHD)患者的血清全段甲状旁腺素(intact parathyroid hormone,iPTH)、甲状旁腺素1-84(parathyroid hormone1-84,PTH1-84)、骨碱性磷酸酶(bone alkaline phosphatase,BALP)及骨钙素(osteocalcin,OC)浓度的测定,试评价不同的骨转运指标在诊断肾性骨病中的意义。方法选择首都医科大学附属复兴医院维持性血液透析患者74名,采集临床病史及生化系列结果;健康对照组30名。应用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)分别测定2组血清iPTH、PTH1-84、BALP、OC浓度;甲状旁腺素7-84(parathyroid hormone7-84,PTH7-84)浓度由iPTH、PTH1-84相减而得。结果血液透析组患者的血清iPTH、PTH1-84、PTH7-84、BALP均高于正常对照组,差异有统计学意义(P<0.01);血清OC浓度明显高于对照组,差异有统计学意义(P=0.050)。血透患者的iPTH、PTH1-84均与BALP、OC呈显著正相关(P=0.000)。iPTH与PTH1-84呈显著正相关(r=0.691,P=0.000)。结论血液透析组患者的iPTH与PTH1-84浓度升高,并且与BALP、OC显著相关。将甲状旁腺素的测定与BALP、OC等骨转运指标联合应用,对于肾性骨病的临床诊断有一定的意义。 Objective This study was to evaluate the intact parathyroid hormone（iPTH） and parathyroid hormone1-84（PTH1-84） assay with bone turnover markers,such as bone alkaline phosphatase（BALP） and osteocalcin（OC） in maintenance hemodialysis（MHD） patients.Methods Totally 74 hemodialysis patients were enrolled in this study.Clinical data were collected.The control group included 30 healthy people.The serum iPTH,PTH1-84,BALP and OC levels were determined by a specific enzyme linked immunosorbent assay（ELISA）.Parathyroid hormone7-84（PTH7-84） level was calculated by iPTH minus PTH1-84.Results The serum iPTH,PTH1-84,BALP levels were significantly higher in MHD patients than in control group（P=0.000）.The serum OC levels was higher in MHD patients than in control group（P=0.050）.In MHD patients,the serum iPTH and PTH1-84 showed a significant correlation with BALP and OC,respectively（P=0.000）.The serum levels of PTH1-84 and conventional iPTH showed a close correlation in dialysis patients（r=0.691,P=0.000）.Conclusion Circulating iPTH and PTH1-84 levels are one turnover markers.Combined use of PTH determination with bone turnover markers BALP and OC may be contributive to diagnosis of renal osteodystrophy（ROD）.

作者贾艳丽刘惠兰

机构地区首都医科大学附属复兴医院肾内科

出处《首都医科大学学报》 CAS 北大核心 2010年第6期803-807,共5页 Journal of Capital Medical University

关键词血液透析甲状旁腺素骨转运 hemodialysis parathyroid hormone bone turnover

分类号 R691 [医药卫生—泌尿科学]

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参考文献11

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