维持性血液透析患者继发性甲状旁腺功能亢进超声表现及相关因素分析

目的 了解维持性血液透析患者继发性甲状旁腺功能亢进（SHPT）的超声表现,并探讨其相关因素.方法 对我院73例维持性血液透析SHPT患者行甲状旁腺超声检查,分为显示组与未显示组.显示组记录病灶部位、数目、大小、回声及血流情况,再分为血流丰富组和血流不丰富组、钙化组和未钙化组.所有病例均结合甲状旁腺激素（PTH）、碱性磷酸酶（ALP）、钙（Ca）、磷（P）、年龄、性别、透析病程等相关因素进行分析.结果 73例SHPT患者中有57例检出甲状旁腺（78.1％）,超声表现主要为甲状腺左右叶背侧1～4个不等椭圆形或类圆形低回声结节.显示组的血清PTH、ALP、Ca、透析病程明显高于未显示组,且甲状旁腺的数目、大小与血清PTH、ALP呈正相关.血流丰富组的PT H、ALP、P、CaxP明显高于血流不丰富组;钙化组的ALP、Ca、透析病程明显高于未钙化组.结论 SHPT患者甲状旁腺超声显示率高,且有特征性的表现,超声检查能为临床提供一定的诊治依据.

Ultrasonography and correlative factor of secondary hyperparathyroidism in maintenance hemodialysis patients

Objective To realize ultrasonography and correlative factor of secondary hyperparathyroidism in maintenance hemodialysis patients.Methods 73 maintenance hemodialysis patients with secondary hyperparathyroidism were divided into imaging group and no imaging group.The patients were underwent ultrasonic,PTH,ALP,Ca,P testing and recorded age,sex,duration of dialysis.The location,number,size,echo and blood flow in imaging group were recorded.Imaging group was divided into rich blood flow group and no rich blood flow group according to blood flow and divided into calcification group and no calcification group according to level of serum calcium.Results 57 patients had parathyroid gland image in 73 patients with SHPT （78.1％）.The ultrasound findings had 1 to 4 low level echo nodes around the thyroid lobe dorsal.Serum value of PTH,ALP,Ca and duration of dialysis in imaging group were higher than that in no imaging group.Number and size of parathyroid gland were positive correlation to serum value of PTH and ALP.Value of PTH,ALP,P and Ca× P in rich blood flow group was higher than that in no rich blood flow group.Value of ALP,Ca and duration of dialysis in calcification group were higher than that in no calcification group.Conclusion Ultrasound image of parathyroid gland is high,representative in SHPT patients.Ultrasound testing could provide the secundum for clinical diagnosis and treatment.