|本期目录/Table of Contents|

[1]陈亚巍,孙新增,张 萍,等.非糖尿病SHPT血液透析患者行PTX+AT对钙磷代谢和胰岛素分泌的影响[J].天津医科大学学报,2018,24(06):532-535.
　CHEN Ya-wei,SUN Xin-zeng,ZHANG Ping,et al.Effects of parathyroidectomy with autotransplantation on calcium- phosphorus disorder and insulin secretion in non-diabetic uremic patients with SHPT[J].Journal of Tianjin Medical University,2018,24(06):532-535.
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非糖尿病SHPT血液透析患者行PTX+AT对钙磷代谢和胰岛素分泌的影响(PDF)
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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
24卷
期数:
2018年06期
页码:
532-535
栏目:
临床医学
出版日期:
2018-11-20

文章信息/Info

Title:
Effects of parathyroidectomy with autotransplantation on calcium- phosphorus disorder and insulin secretion in non-diabetic uremic patients with SHPT
作者:
陈亚巍; 孙新增; 张 萍; 陶新朝
（中国人民解放军第254医院肾脏内科，天津300142）
Author(s):
CHEN Ya-wei; SUN Xin-zeng; ZHANG Ping; TAO Xin-chao
（Department of Nephrology，Chinese PLA 254th Hospital，Tianjin 300142，China）
关键词:
维持性血液透析; 继发性甲状旁腺功能亢进; 甲状旁腺切除术; 胰岛素
Keywords:
maintenance hemodialysis;  secondary hyperparathyroidism;  total parathyroidectomy;  insulin
分类号:
R605
DOI:
-
文献标志码:
A
摘要:
目的：观察非糖尿病维持性血液透析（MHD）患者并发继发性甲状旁腺亢进（SHPT） 后行甲状旁腺全切术＋前臂移植（ PTX+AT）钙磷和糖代谢指标的变化。方法：回顾性分析84例MHD并发SHPT的临床资料，其中52例SHPT患者行PTX+AT手术治疗，32例行药物治疗，观察治疗前后全段甲状旁腺激素（iPTH）、血钙（Ca）、血磷（P）、血碱性磷酸酶（ALP）等指标的变化，以及患者空腹血糖、胰岛素水平变化。结果：PTX+AT术后，患者血Ca、P、iPTH和ALP水平明显降低，术后1周胰岛素水平开始明显升高，差异具有统计学意义（P<0.05）；而药物治疗组1个月和3个月血P、iPTH明显降低，但6个月后恢复至治疗前水平，且ALP水平明显增高，血糖和胰岛素水平无显著性变化。结论： PTX+AT是治疗SHPT的有效手段，可明显降低血iPTH水平，调节钙磷代谢紊乱；同时可以增加胰岛素分泌。
Abstract:
Objective: To observe the effects of PTX+AT on calcium-phosphorus disorder and insulin secretion for non-diabetic uremic patients with SHPT. Methods:Eighty-four MHD with SHPT patients were enrolled, and their data were retrospectively analyzed. Fifty-two SHPT patients were treated with PTX+AT and thirty-two patients were treated with medicine. Serum intact parathyroid hormone (iPTH), calcium (Ca), phosphorus (P)，alkaline phosphatase (ALP) and fasting insulin obtained preoperatively and postoperatively were collected and compared. Results: Serum iPTH, Ca, and P decreased significantly in postoperative period (P<0.05) and fasting insulin began to increase significantly in one week after the operation (P<0.05). After one month and three months of medical treatment, the level of iPTH and P decreased significantly.But after six months the effect disappeared, and ALP level increased significantly. The change of fasting glucose and insulin had was not statistically significant. Conclusion: PTX+AT can effectively decrease iPTH level and regulate the calcium-phosphorus disorder, so it is an effective operation for uremic patients with SHPT. It can also promote the secretion of insulin.

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备注/Memo

备注/Memo:
作者简介 陈亚巍（1981-），主治医师，博士，研究方向：慢性肾脏病-矿物质和骨代谢异常（CKD-MBD）及其并发症，E-mail:tjcywei1981@163.com。
更新日期/Last Update: 2018-11-30