摘要
目的 回顾性分析继发性甲状旁腺功能亢进(SHPT)并接受了甲状旁腺切除术(PTX)患者的年龄分布与临床营养指标特点,探讨严重SHPT的易发人群.方法 收集2011-2015年在南京医科大学第一附属医院接受PTX的496例SHPT患者的临床资料,按照患者的年龄层分布分组,用单因素方差分析法比较各年龄层患者临床营养指标的差异,Spearman相关分析法分析患者全段甲状旁腺素(iPTH)与营养指标的相关性.结果 496例患者中男274例,平均年龄(46.0±11.4)岁.原发病因以慢性肾小球肾炎为主(92.1％).平均透析龄(7.7±3.6)年,血液透析占92.9％.患者平均血清钙(2.6±0.2) mmol/L;血清磷(2.2±0.5)mmol/L;血清iPTH(2290.0±1294.2) ng/L;血清碱性磷酸酶(ALP) (564.7±537.8) U/L.按照年龄层分组的各组患者血清白蛋白(Alb)水平均低于正常参考值范围.各年龄层组患者血钙、ALP和iPTH水平的差异具有统计学意义(P＜0.05).与年龄≤18岁组和19～30岁组相比,61～70岁组患者ln[ALP]降低(P＜0.05).结论 严重SHPT以青中年、长期血透患者为主,原发病以慢性肾小球肾炎居多.营养状态不佳的严重SHPT患者PTX术前应关注并改善其营养状况,以提高手术耐受性,减少术后并发症.
Objective To retrospectively analyze the characteristics of age distribution and clinical nutritional parameters in secondary hyperparathyroidism (SHPT) patients undergoing parathyroidectomy (PTX).Methods Clinical data of 496 SHPT patients undergoing PTX from 2011 to 2015 in the First Affiliated Hospital with Nanjing Medical University were collected and recorded.Age stratification of SHPT patients was observed.The levels of nutritional parameters in different age groups were compared using ANOVA analysis.The relationship between intact parathyroid hormone (iPTH) and nutritional parameters was explored using Spearman's correlation.Results There were 274 males in 496 SHPT patients who were aged (46.0± 11.4) years.Chronic glomerulonephritis was the major primary cause of patients (92.1％).Their dialysis vintage was (7.7±3.6) years.The proportion of SHPT patients receiving hemodialysis was 92.9％.In SHPT patients serum levels of calcium,phosphorus,iPTH and alkaline phosphatase (ALP) were (2.6±0.2) mmol/L,(2.2±0.5) mmol/L,(2290.0± 1294.2) ng/L,and (564.7±537.8) U/L,respectively.Levels of serum albumin (Alb) in all age groups were lower than the reference range.Serum calcium,ALP,and iPTH levels among age groups were different with statistical significance,while serum phosphorus levels among age groups shown no statistically significant difference.Compared with patients aged ≤ 18 years old and 19～30 years old,the level of In[ALP] was lower in patients aged 61-70 years old (P ＜ 0.05).Conclusions Severe SHPT patients are mainly receiving hemodialysis and aged between 30 and 60 years old.Chronic glomerulonephritis is a primary cause of SHPT patients.In order to increase the patients' endurance of operations and reduce the occurrence of postoperative complications,malnutrition in SHPT patients is to be alleviated before PTX.
出处
《中华肾脏病杂志》
CSCD
北大核心
2016年第8期592-597,共6页
Chinese Journal of Nephrology
基金
国家自然科学基金(81270408、81570666)%中华医学会临床科研专项基金首届肾脏病青年研究基金(13030300415)%江苏省“医学重点人才”项目(RC201162)%江苏省肾脏病临床研究项目(BL2014080)National Natural Science Foundation of China(81270408,81570666)%Chinese Society of Nephrology(13030300415)%Jiangsu Province Key Medical Personnel Project(RC201162)%Clinic Research Center of Jiangsu Province(BL2014080)
