目的 分析继发性甲状旁腺功能亢进(secondary hyperpar hyroidism,SHPT)患者行甲状旁腺全切术(T-parathyroidectomy,T-PTX)前后血清成纤维细胞生长因子-23(fibroblast growth factor -23 ,FGF-23)及炎性因子的变化,并探讨其变化的意义。方法 选取2011-01至 2013-01武警总医院肾内科行T-PTX术成功的患者40例做为研究对象,术后均行普通血液透析治疗,排除血液透析滤过及灌流对实验的影响,收集其术前、术后1 d、1、3、6个月血清,对比不同时间点血清FGF23、全段甲状旁腺激素(iPTH)和血清钙、血磷、hsCRP检测结果。结果 (1)术后1 d及1、3、6个月血清FGF-23、iPTH、血清钙、血磷水平明显低于术前,差异有统计学意义(P<0.05);(2)术后1 d血清hsCRP水平较术前无统计学意义,术后1、3、6个月血清hsCRP水平[(2.64±1.32 vs 20.31±8.56)mg/L、(2.16±1.08 vs 20.31±8.56)mg/L、(1.38±0.17 vs 20.31±8.56)mg/L]明显低于术前的(11.72±5.21 vs 20.31±8.56)mg/L,差异有统计学意义(P<0.05)。结论 T-PTX可有效降低患者血清FGF23、PTH及炎性因子水平,纠正钙磷代谢紊乱,对减少远期心血管事件及骨矿物质代谢疾病有重要意义。
Abstract
Objective To analyze the changes of serum fibroblast growth factor -23 (FGF-23) and inflammatory factors of secondary hyperparathyroidism (SHPT) patients who had undergone total parathyroidectomy, and explore the significance of these changes.Methods Forty SHPT patients treated with T-PTX between January 2011 and January 2013 in the Department of Nephrology, Armed Police General Hospital, were enrolled in this study. Each patient was given hemodialysis. Serum FGF -23, parathyroid hormone (PTH), calcium(Ca), phosphorus (P) and high sensitivity reactive protein (hsCRP) obtained during the preoperative, postoperative and follow-up periods were collected and compared.Results (1)Serum levels of FGF-23, PTH, Ca, P, and hsCRP decreased significantly one day, one month, three months and 6 months after PTX (P＜0.05). (2)Levels of serum hsCRP decreased one day after PTX, but not significantly. Serum hsCRP was (20.31±8.56)mg/L before PTX, and was (11.72±5.21) mg/L, (2.64±1.32) mg/L, and (2.16±1.08)mg/L respectively 1 month, 3 months, and 6 months after PTX (P＜0.05).Conclusions T-PTX can effectively reduce the levels of serum FGF-23, PTH and inflammatory factors, correct the disturbance of Ca and P metabolism, and reduce the incidence of long-term cardiovascular events and bone metabolism diseases.
关键词
继发性甲状旁腺功能亢进 /
成纤维细胞生长因子-23 /
甲状旁腺全切除术
Key words
secondary hyperparathyroidism /
serum fibroblast growth factor -23 /
T-PTX
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