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目的:观察术后早期PTH水平与临床表现及长期预后关系。方法:回顾性分析2007年6月至2012年6月在温州医科大学附属第一医院行PTX+AT的81例慢性肾衰伴SHPT患者临床资料。以术后第一天PTH(PTH1)60ng/L为界,分为A组(PTH1>60ng/L)和B组(PTH1≤THng/L),收集患者术前、术后以及长期随访的甲状旁腺激素(PTH)和血钙水平,统计复发与持续性状态情况并进行比较分析。结果:81例患者中79例术后6月血钙控制满意。A组病例术后早期PTH、血钙均明显高于B组,临床表现上,出现手足口唇发麻或抽搐低钙的几率低于B组(P<0.05)。2年随访结果显示,A组病例持续性状态或复发几率均高于B组(P<0.05)。结论:PTX+AT是治疗SHPT的一种安全有效的方法,PTH1≤TH安全有效不仅在术后早期会有更明显的低钙表现,而且提示有更好的长期预后。
Objective: To observe the relationship between early PTH and clinical manifestations and long-term prognosis. Methods: The clinical data of 81 patients with chronic renal failure and SHPT who underwent PTX + AT at the First Affiliated Hospital of Wenzhou Medical University from June 2007 to June 2012 were retrospectively analyzed. The patients were divided into A group (PTH1> 60ng / L) and B group (PTH1≤THng / L) on the first day of postoperative PTH (PTH1) 60ng / L, and the patients’ preoperative, postoperative and long-term follow- Parathyroid hormone (PTH) and serum calcium levels, statistical status of recurrence and persistent status and comparative analysis. Results: 79 of 81 patients were satisfied with the blood calcium control at 6 months after operation. In group A, the early postoperative PTH and serum calcium were significantly higher than those in group B. In clinical manifestations, there was a lower incidence of numbness or seizures of hands and feet than those in group B (P <0.05). The 2-year follow-up results showed that the persistent status or the recurrence probability of patients in group A were higher than those in group B (P <0.05). Conclusions: PTX + AT is a safe and effective method for the treatment of SHPT. PTH1≤TH is safe and effective not only in the early postoperative period, but also has a better long-term prognosis.