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目的分析维持性血液透析(MHD)患者罹患继发性甲状旁腺功能亢进症(SHPT)的患病率及发病特点。方法连续纳入我院血透室2005年7月-2014年7月MHD患者135例,其中男70例,女65例。测定血清钙、磷、全段甲状旁腺激素(i PTH)水平。结果 MHD并发SHPT共59例(43.70%),其中<65岁者47例(34.81%),>65岁者12例(8.89%);其i PTH范围7~2230(347.28±29.43)pg/ml;透析龄>3年39例(28.89%),透析龄<3年20例(14.81%)。高磷血症61例(45.19%),血磷水平0.79~4.03(1.84±0.57)mmol/L,低钙血症30例(22.22%),血钙1.66~2.83(2.23±0.21)mmol/L;钙磷乘积>55mg/dl的患者36例(26.67%),钙磷乘积(49.28±16.21)mg/dl。结论 MHD患者罹患SHPT的发病率高、预后差,基层医院亟待规范化筛查及治疗。
Objective To analyze the prevalence and incidence of secondary hyperparathyroidism (SHPT) in patients with maintenance hemodialysis (MHD). Methods Thirty-one MHD patients were enrolled in our hospital from July 2005 to July 2014, including 70 males and 65 females. Serum calcium, phosphorus, total parathyroid hormone (i PTH) levels were measured. Results There were 59 cases (43.70%) with MHD complicated with SHPT, of which 47 cases (34.81%) were under 65 years old and 12 cases (8.89%) were over 65 years old. The range of i PTH was 7-2230 (347.28 ± 29.43) pg / ml ; Dialysis age> 3 years 39 cases (28.89%), dialysis age <3 years 20 cases (14.81%). 61 cases of hyperphosphatemia (45.19%), serum phosphorus level of 0.79 ~ 4.03 (1.84 ± 0.57) mmol / L, hypocalcemia in 30 cases (22.22%) and calcium of 1.66 ~ 2.83 (2.23 ± 0.21) mmol / L 36 patients (26.67%) had calcium-phosphorus product> 55mg / dl, and 49.28 ± 16.21 mg / dl of calcium-phosphorus product. Conclusion The incidence of SHPT in patients with MHD is high, and the prognosis is poor. The primary hospitals need to be standardized for screening and treatment.