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目的:探讨慢性肾衰竭(CRF)维持性血液透析患者血清甲状旁腺激素(PTH)水平与机体营养状况的关系。方法:选择2013年8月-2015年10月我院收治的慢性肾衰竭行维持性血液透析治疗的患者98例作为研究组,另选择同期接受健康体检的志愿者69例作为对照组。采用放射免疫法检测两组患者血清甲状旁腺激素(PTH)及血清学指标。采用微型营养评定法(MNA)评价两组患者营养状况;利用Spearman相关分析方法评价血清PTH与相关血清生化指标的相关性。结果:研究组营养不良发生率(31.63%)明显高于对照组(13.04%),差异具有统计学意义(P<0.05)。研究组营养不良患者血清PTH,HDL-C,LDL-C,CRP,BUN及SCr水平均高于潜在营养不良和营养正常者,而血清TP,ALB,TC,TG及Hb均低于潜在营养不良和营养正常者(P<0.05)。潜在营养不良患者血清PTH,HDL-C,LDL-C,CRP,BUN及SCr水平均高于营养正常者,而血清TP,ALB,TC,TG及Hb均低于营养正常者(P<0.05)。慢性肾衰竭患者血清PTH与MNA,TP,TC,TG,CRP以及Hb呈负相关关系(P<0.05);与BUN,SCr呈正相关关系(P<0.05);与ALB,HDL-C,LDL-C无明显相关性(P>0.05)。结论:CRF患者并发营养不良的发生率较高,血清PTH水平与机体营养状况存在一定相关性,临床应予以重视。
Objective: To investigate the relationship between the level of serum parathyroid hormone (PTH) and nutritional status of chronic renal failure (CRF) patients with hemodialysis. Methods: From August 2013 to October 2015, 98 patients with chronic renal failure who underwent maintenance hemodialysis in our hospital were selected as the study group. Another 69 volunteers were selected as the control group during the same period. Serum parathyroid hormone (PTH) and serological markers were detected by radioimmunoassay in two groups. The nutritional status of patients in both groups was evaluated by mini-nutritional assessment (MNA). Spearman correlation analysis was used to evaluate the correlation between serum PTH and related serum biochemical parameters. Results: The incidence of malnutrition in study group (31.63%) was significantly higher than that in control group (13.04%), the difference was statistically significant (P <0.05). Serum levels of PTH, HDL-C, LDL-C, CRP, BUN and SCr were significantly higher in patients with malnutrition than in those with underlying malnutrition and malnutrition, while the levels of serum TP, ALB, TC, TG and Hb were all lower than those with underlying malnutrition And normal nutrition (P <0.05). Serum levels of PTH, HDL-C, LDL-C, CRP, BUN and SCr in patients with underlying malnutrition were significantly higher than those in patients with normal nutrition, while serum TP, ALB, TC, TG and Hb in serum were lower than those in normal nutrition (P < . HDL-C, LDL-C were positively correlated with BUN and SCr (P <0.05). There was a positive correlation between serum PTH and MNA, TP, TC, TG, CRP and Hb in chronic renal failure patients (P < C no significant correlation (P> 0.05). Conclusions: The incidence of malnutrition complicated by CRF is high. The serum PTH level has some correlation with the nutritional status of the body, and should be paid more attention in clinic.