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目的:探讨糖尿病肾病(diabtic nephropgthy,DN)与非糖尿病肾病(non-DN)维持性血液透析患者(maintenance hemodialysis,MHD)血钙、血磷、甲状旁腺激素(intact parathyroid hormone,iPTH)水平的差异;分析其血钙、血磷、iPTH和糖化血红蛋白(glycosylated hemoglobin,HbA1c)水平的相关性。方法:选择沈阳军区总医院血液透析中心收治的148例MHD患者,分为糖尿病组(58例)和非糖尿病组(90例),比较两组间血钙、血磷、甲状旁腺激素水平的差异,并分析其血钙、血磷、iPTH、HbA1c水平的相关性。结果:糖尿病组iPTH、血磷水平均明显低于非糖尿病组(P<0.05),两组血钙水平比较无明显差异。在非DN组中,iPTH与血钙水平呈显著负相关(r=-0.320,P=0.036),iPTH与血磷水平呈明显正相关(r=0.426,P=0.005)。在DN组中,iPTH与血钙、血磷无显著相关性,而iPTH与HbA1C水平呈显著负相关(r=-0.732,P=0.007)。结论:糖尿病肾病血液透析患者的iPTH水平和血磷水平明显低于非糖尿病肾病血液透析患者,HbA1c可能抑制iPTH的分泌。
Objective: To investigate the levels of serum calcium, phosphorus and intact parathyroid hormone (iPTH) in patients with diabtic nephrophthy (DN) and non-diabetic nephropathy (maintenance hemodialysis) Differences; Analysis of their serum calcium, phosphorus, iPTH and glycosylated hemoglobin (HbA1c) levels. Methods: A total of 148 patients with MHD were enrolled in the Hemodialysis Center of Shenyang Military Region General Hospital. They were divided into diabetic group (58 cases) and non-diabetic group (90 cases). The levels of serum calcium, phosphorus, parathyroid hormone Differences, and analysis of its serum calcium, phosphorus, iPTH, HbA1c levels. Results: The levels of iPTH and P in diabetic patients were significantly lower than those in non-diabetic patients (P <0.05). There was no significant difference in serum calcium between the two groups. In non-DN group, iPTH was negatively correlated with serum calcium (r = -0.320, P = 0.036), and iPTH was positively correlated with serum phosphorus (r = 0.426, P = 0.005). In DN group, there was no significant correlation between iPTH and blood calcium and phosphorus, but negative correlation between iPTH and HbA1C (r = -0.732, P = 0.007). Conclusion: The levels of iPTH and serum phosphorus in hemodialysis patients with diabetic nephropathy are significantly lower than those in non-diabetic renal hemodialysis patients, and HbA1c may inhibit the secretion of iPTH.