维持性血液透析继发性甲状旁腺功能亢进患者甲状旁腺切除术后严重低钙血症危险因素分析

史玉萍; 戎殳; 杨满; 张政; 袁伟杰

doi:10.3969/j.issn.1671-4091.2019.12.006

中国血液净化 >

2019 , Vol. 18 >Issue 12: 830 - 833

DOI: https://doi.org/10.3969/j.issn.1671-4091.2019.12.006

临床研究

维持性血液透析继发性甲状旁腺功能亢进患者甲状旁腺切除术后严重低钙血症危险因素分析

史玉萍 ,
戎殳 ,
杨满 ,
张政 ,
袁伟杰

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1. 上海交通大学附属第一人民医院肾内科

收稿日期: 2019-07-11

修回日期: 2019-10-03

网络出版日期: 2019-12-03

基金资助

国家自然科学基金(课题编号: 81970636)；上海市第一人民医院临床研究创新团队建设项目(CTCCR-2018C09)

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Analysis of risk factors for severe hypocalcemia in maintenance hemodialysis patients with secondary hyperparathyroidism after parathyroidectomy#br#

SHI Yu-Ping ,
RONG Shu ,
YANG Man ,
ZHANG Zheng ,
YUAN Wei-Jie

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1Department of Nephrology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China

Received date: 2019-07-11

Revised date: 2019-10-03

Online published: 2019-12-03

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摘要

【摘要】目的探讨甲状旁腺切除(parathyroidectomy，PTX)治疗继发性甲状旁腺功能亢进(secondary hyperparathyroidism，SHPT)导致维持性血液透析(maintenance hemodialysis，MHD)患者发生术后严重低钙血症(severe hypocalcemia，SH)危险因素。方法收集2010 年5 月～2018 年5 月上海交通大学附属第一人民医院接受甲状旁腺切除的MHD 并发SHPT 患者59 例临床资料，根据术后血钙水平分为2组，A 组为SH 组，B 组为非SH 组，采用多元Logistic 回归分析确定术后发生严重低钙血症危险因素。结果59 例患者术后发生低钙血症49 例；SH 32 例；多元回归分析显示2 组间术前碱性磷酸酶(β=0.185，P=0.045)、术前甲状旁腺激素(β=0.004，P=0.040)、干体质量(β=0.027, P=0.034)是术后SH 的危险因素。结论术前碱性磷酸酶、术前甲状旁腺激素、干体质量是MHD 患者接受PTX 术后发生SH 危险因素。

关键词： 肾性甲状旁腺功能亢进; 维持性血液透析; 甲状旁腺切除术; 严重低钙血症

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史玉萍 , 戎殳 , 杨满 , 张政 , 袁伟杰 . 维持性血液透析继发性甲状旁腺功能亢进患者甲状旁腺切除术后严重低钙血症危险因素分析[J]. 中国血液净化, 2019 , 18(12) : 830 -833 . DOI: 10.3969/j.issn.1671-4091.2019.12.006

Abstract

【Abstract】Objective To investigate the risk factors for postoperative severe hypocalcemia (SH) in maintenance hemodialysis (MHD) patients with secondary hyperparathyroidism (SHPT) after parathyroidectomy (PTX). Method The clinical data of 59 MHD patients with SHPT and undergoing PTX in Shanghai General Hospital from May 2010 to May 2018 were collected. Based on postoperative serum calcium level, they were divided into group A (with SH) and group B (without SH). Multivariate logistic regression analysis was used to determine the risk factors for postoperative SH. Results Among the 59 patients, hypocalcemia occurred in 49 cases and SH in 32 cases. Multivariate regression analysis showed that preoperative alkaline phosphatase (β= 0.185, P=0.045), preoperative parathyroid hormone (β=0.004, P=0.040) and dry weight (β=0.027, P=0.034) were the risk factors for postoperative SH. Conclusion Preoperative alkaline phosphatase, preoperative parathyroid hormone and dry weight are the risk factors for SH in MHD patients with SHPT after PTX.

Key words： Renal hyperparathyroidism; Maintenance hemodialysis; Parathyroidectomy; Severe hypocalcemia

参考文献

参考文献
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