透析患者甲状旁腺机能亢进与左心室肥厚的关系

目的　了解透析患者甲状旁腺机能亢进与左心室肥厚 (L VH)的相关关系。方法　分别测量我院 46例腹膜透析 (CAPD)患者、73例血液透析 (HD)患者、18例透析前慢性肾衰竭患者及 16例健康人的超声心动图 ,以了解左心室肥厚的发生率 ,并分别检查血甲状旁腺素 (i PTH)、钙、磷水平 ,分析血钙、磷、i PTH与 L VH之间的关系。结果　CAPD组、HD组、肾衰竭组的 i PTH较对照组明显增高 (P<0 .0 0 1) ,以肾衰竭组升高明显 ,并且与 L VH呈显著正相关 (r=0 .70 5 ,P<0 .0 0 1)。 CAPD组、HD组的血钙值、血磷值与对照组无明显差别 ,而慢性肾衰竭组则血钙明显低下、血磷明显升高。结论　尿毒症患者普遍存在甲状旁腺机能亢进 ,是导致透析患者心血管疾病发病率增高的原因之一

Relationship between hyperparathyroidism and left ventricular hypertrophy in dialysis patients

Objective To investigate the correlation between left ventricular hypertrophy (LVH) and hyperparathyroidism in dialysis patients. Methods 46 peritoneum dialysis (CAPD) patients, 73 hemodialysis (HD) patients and 18 chronic renal failure (CRF) patients were included in this study, 16 healthy adults were served as the control group. The presence of LVH was determined by ultrasonic cardiography(UCG), the parathyroid hormone(iPTH), plasma calcium and phosphate levels were also tested. Results The parathyroid hormone levels were significantly higher in uremic patients than those in control groups( P <0.001), especially in CRF patients. There was significantly positive correlations between LVH and iPTH. The calcium and phosphate levels had no significantly difference in CAPD,HD group and control group, whereas the calium levels in CRF group was significantly lower, and the phosphate level was significantly higher. Conclusion The incidence of hyperparathyroidism in uremic patients in our hospital is common, and the association between hyperparathyroidism and LVH suggests that hyperparathyroidism may also be a key factor in the pathogenesis of cardiovascular disease in uremic patients.