摘要
目的探讨维持性血液透析(MHD)患者改善高甲状旁腺素(iPTH)血症对肾性贫血的影响。方法选择我院血透中心iPTH>600ng/ml,透析6月以上,正规应用人重组促红细胞生成素(rhEPO)维持性血液透析肾性贫血患者23例,活性维生素D3治疗6月,治疗前后检测血Hb、Hct、Ca、Pi、Fer、iPTH的变化。结果23例治疗后,iPTH水平由(978.78±281.86)μg/ml下降至(313.53±66.89)μg/ml,rhEPO用量由(8153.84±875.73)U/W减少至(7066.66±2062.22)U/W:Hb由(89.61±13.84)g/L上升至(99.3±20.82)g/L,Hct由0.265±0.39上升至0.2941±0.063。结论继发性甲状旁腺功能亢进是rhEPO抵抗的原因之一,针对继发性甲状旁腺功能亢进治疗可以改善肾性贫血。
Objective To observe the impact of different levels of immunoreactive parathyroid hormone （iPTH） on renal anemia in patients undergoing maintenance hemodialysis. Methods Twenty-three patients whose iPTH 〉 600 ng/ml, receiving maintenance hemodialysis over 6 months and recombinate hemopoietin treatment, were selected and treated with active vitamin D3 for 6 months . The levels of Hb, Hct, Ca,Pi,Fer , iPTH were measured before and after vitamin D3 treatment. Results After treatment by active vitamin D3, iPTH declined from （978. 78 ±281.86） μg/ml to （313.53 ±66. 89）μg/ml,the mean Hb level elevated from （89. 61± 13.84）g/L to （99. 3 ±20. 82）g/L, the mean Het elevated from 0. 265 ±0. 39 to 0. 2941±＋0. 063, and the mean dosage of rhEPO declined from （ 8153. 84 ± 875.73 ） IU/W to （ 7066. 66±2062. 22 ） IU/W. Conclusion Secondary hyperparathyroidism is responsible for rhEPO resistance. Therapeutic regimens against secondary hyperparathyroidism may ameliorate renal anemia.
出处
《实用医院临床杂志》
2007年第5期38-39,共2页
Practical Journal of Clinical Medicine
