维持性血液透析患者甲状旁腺超声筛查的临床意义

目的 探讨维持性血液透析（maintenance hemodialysis,MHD）患者实施甲状旁腺（parathyroid,PT）超声检查的临床意义.方法 收集MHD治疗1年以上患者的一般资料和相关实验室检查,根据全段甲状旁腺激素（intact parathyroid hormone,iPTH）水平分为A组（≥600pg/ml）和B组（＜600pg/ml）实施PT超声检查.结果 有73例患者入选,其中A组55例,B组18例.A组PT超声检出率90.9％（50/55）,B组PT超声检出率33.3％（6/18）,差异有统计学意义（P＜0.001）；A、B2组间PT总体积存在显著性差异（t=4.171,P=-0.021）,单因素分析显示,iPTH水平与PT体积呈正相关（γ=0.543,P=0.039）.结论 iPHT水平高于600pg/ml的MHD患者,高度提示存在PT增生的可能.

The clinical significance of parathyroid examination by ultrasonography in hemodialysis patients

Objective To investigate the clinical significance of parathyroid （PT） examination by ultraso- nography in maintenance hemodialysis （MHD） patients. Methods Seventy-three patients on MHD for more than one year were enrolled in this study. Their clinical information and laboratory parameters were collected. They were assigned into group A （iPTH ≥ 600 pg/ml, n=55） or group B （iPTH 〈600 pg/ml, n=18）. Their PTs were examined by ultrasonography. Results Abnormal PT was detected in 50 of the 55 cases in group A （90.9%） and 6 of the 18 cases in group B （33.3%; P 〈0.001）. Total PT volume was significantly different be- tween the two groups （t=-4.171, P=-0.021）. Univariate analysis showed that iPTH level was positively correlat- ed with PT volume （γ = 0.543, P= 0.039）. Conclusion MHD patients with iPHT level 〉600 pg/ml are highly suggestive of the presence of PT hyperplasia.