影响慢性肾脏病患者血清甲状旁腺素的相关因素分析

Abstract

目的：甲状旁腺激素(parathyroid hormone, PTH)，是甲状旁腺主细胞分泌的碱性单链多肽类激素，在慢性肾病的并发症发病中日益显示其重要性。通过检测本肾病中心599例慢性肾病患者的PTH值，探讨不同阶段的慢性肾病PTH异常率的差异，并分析性别和年龄是否影响慢性肾病患者的PTH值。方法：利用化学发光免疫夹心法检测PTH浓度。结果：统计结果显示尿毒症患者组的PTH异常率显著高于非尿毒症患者组(P = 0.02)；男性尿毒症患者的PTH异常率明显高于女性尿毒症患者(P = 0.007)；尤其值得注意的是，无论是尿毒症组还是非尿毒症组，年龄 ≥ 50的慢性肾病患者PTH异常率比年龄 < 50的患者低，且在非尿毒症组具有显著性差异(P = 0.006)。结论：PTH异常与慢性肾脏病的恶化明显相关，年龄因素参与慢性肾病患者PTH调控的机理有待进一步阐明。 Objective: Parathyroid hormone (PTH), is a basic single chain polypeptide hormone secreted by parathyroid cells, has become increasingly important in the pathogenesis of chronic kidney disease. By testing the PTH value of 599 patients with chronic kidney disease (CKD), we investigate the dif-ference of PTH abnormal rate in different stages of chronic kidney disease, and analyze whether the gender and age affect the PTH value of patients with chronic kidney disease. Methods: The concen-tration of PTH was detected by chemiluminescence immunoassay. Results: Statistical results showed that the abnormal rate of PTH in uremic patients was significantly higher than that in non-uremic patients (P = 0.02). The abnormal rate of PTH in male uremic patients was significantly higher than that in female patients with uremia (P = 0.007). In particular, it was worth noting that, in both uremic group and non-uremic group, the PTH abnormal rate of the CKD patients aged ≥50 was lower than that of age < 50, and there was a significant difference in the non-uremic group (P = 0.006). Conclusion: PTH abnormalities were significantly correlated with the progression of chronic kidney disease, and the mechanism of PTH influenced by the age in CKD patients needed to be further clarified.