摘要
目的研究维持性血液透析(MHD)继发性甲状旁腺功能亢进(HPT)患者甲状旁腺增生的超声特征及影响因素。方法纳入我院收治的MHD继发性HPT患者140例,所有患者均行超声检查,记录甲状旁腺的大小、数量、形态、血流、位置、回声等信息。将超声检查诊断为甲状旁腺增生的患者纳入增生组,非甲状旁腺增生的患者纳入对照组,比较两组的临床资料。使用多因素Logistic回归分析MHD继发性PHT患者甲状旁腺增生的影响因素。结果MHD继发性HPT患者甲状旁腺增生的超声图像特征主要包括单个或多个甲状旁腺增生,边界多清晰,形状多为类圆形或椭圆形,低回声以及血流信号丰富。增生组的透析时间长于对照组,血清磷、iPTH水平均高于对照组(P<0.05)。多因素Logistic回归分析结果显示,透析时间、血清磷、iPTH均为影响MHD继发性HPT患者甲状旁腺增生发生的独立危险因素(P<0.05)。结论超声可作为MHD继发性HPT患者甲状旁腺增生的推荐诊断方法;MHD继发性HPT患者甲状旁腺增生与血清磷、iPTH和透析时间相关,临床中针对透析时间长、iPTH和血清磷水平高的患者应及时开展甲状旁腺增生筛查,以促进患者预后的改善。
Objective To study the ultrasonic feature and influencing factors of parathyroid hyperplasia in patients with secondary hyperparathyroidism(HPT)after maintenance hemodialysis(MHD).Methods A total of 140 MHD patients with secondary HPT admitted in our hospital were enrolled.All patients underwent ultrasound examination,and the size,number,morphology,blood flow,location,echo and other information of parathyroid gland were recorded.Patients with parathyroid hyperplasia diagnosed by ultrasound examination were included in hyperplasia group,and patients with non-parathyroid hyperplasia were included in control group.The clinical data of the two groups were compared.Multivariate Logistic regression analysis was used to analyze the influencing factors of parathyroid hyperplasia in MHD patients with secondary PHT.Results The ultrasonic image features of parathyroid hyperplasia in MHD patients with secondary HPT mainly included single or multiple parathyroid hyperplasia,clear boundary,quasi circular or oval shape,low echo and rich blood flow signals.The dialysis time in the hyperplasia group was longer than that in the control group,and the levels of serum phosphorus and iPTH were higher than those in the control group(P<0.05).The multivariate Logistic regression analysis showed that dialysis time,serum phosphorus and iPTH were independent risk factors for parathyroid hyperplasia in MHD patients with secondary HPT(P<0.05).Conclusion Ultrasound can be used as a recommended diagnostic method for parathyroid hyperplasia in MHD patients with secondary HPT.Parathyroid hyperplasia in MHD patients with secondary HPT is related to serum phosphorus,iPTH and dialysis time.In clinic,patients with long dialysis time and high levels of iPTH and serum phosphorus should be screened for parathyroid hyperplasia in time to improve the prognosis.
作者
乔艳
罗迎娣
QIAO Yan;LUO Yingdi(the Third Affiliated Hospital of Xi'an Medical University,Xi'an 710068;Chang'an Hospital,Xi'an 710018,China)
出处
《临床医学研究与实践》
2021年第28期47-49,共3页
Clinical Research and Practice
