腹膜透析患者的低甲状旁腺激素血症与营养状态的关系

目的调查腹膜透析患者中低甲状旁腺激素血症的发病情况，以及可能与之相关的因素。方法回顾性研究北京大学第三医院肾内科66例腹膜透析患者，每3个月测定血清iPTH水平，当血清iPTH水平高于300ng／L时使用活性维生素D治疗，并每月测定血清iPTH。同时测定血清白蛋白水平，使用SGA评估患者的营养状况。结果有32％的患者存在持续性低PTH血症，有42％的患者出现暂时性低PTH血症。持续性低PTH血症组患者血清白蛋白水平明显低于暂时性低PTH血症（P=0．024），营养不良的发生率也明显升高（P=0．020）。结论腹膜透析患者中低PTH血症发生率较高，且与营养不良的发生存在一定的关系。对于营养不良的透析患者在使用活性维生素D时应高度注意导致低PTH血症的可能。

Hypoparathyroidism in peritoneal dialysis patients and its relationship with nutritional status

Objective To investigate the prevalence of hypoparathyroidism in peritoneal dialysis patients(PD)and the possible factors related to hypoparathyroidism.Methods Sixty-six peritoneal dialysis patients were involved in this retrospective study.Serum intact parathyroid hormone(iPTH)were detected every 3 months after dialysis,when it exceeded 300 ng/L,calcitriol were administered and iPTH then were rechecked every month.Serum albumin and subjective global assessment(SGA)were used to evaluate the nutritional status.Results Of all patients,32% patients had permanent hypoparathyroidism,and 42% had temporal hypoparathyroidism.Serum albumin level was lower in permanent hypoparathyroidism group than temporal group(P = 0.024),and higher malnutrition rate also could be found in this group(P=0.020).Conclusion Hypoparathyroidism was frequent in PD patients,and it was related to malnutrition.To PD patients with malnutrition,more attention must be paid in the use of calcitriol.