尿毒症血液透析患者预后与甲状旁腺素相对表达量之间的相关性研究

摘要

Objective To investigate the relationship between the relative expression of parathyroid hormone (PTH) and the development of uremia hemodialysis.Methods A total of 96 cases of uremic patients undergoing maintenance hemodialysis were included.The relative expression of PTH was detected by reverse transcription-polymerase chain reaction (RT-PCR),and the correlation between the relative expression of PTH and clinical characteristics was analyzed.The Mann-whitney U test were performed to analyze the PTH expression and the survival rate.Results PTH relative expression of the patient's age,gender,etc.were not correlated (P ＞ 0.05).LVDd,IVST,LVDs,LVMI,edema,intake,serum creatinine,systolic blood pressure and serum PTH levels were positively correlation (P ＜ 0.05),and LVEF,Hb,Alb,Ca and serum PTH levels were negatively correlated (P ＜ 0.05).The relative expression of 42 cases of patients with PTH was significantly lower in patients with diabetic nephropathy 18 cases (42.86％),while 54 cases of patients with high expression of PTH only six cases of diabetic nephropathy (11.11％).The difference was statistically significant,the level of expression of PTH with diabetes mellitus nephropathy was a certain correlation.Conclusion PTH relative expression levels of diabetic nephropathy and prognosis has relevance.Whether PTH relative expression levels in hemodialysis can be considered as a new diagnostic and prognostic marker need further research to verify.%目的 探讨甲状旁腺素(PTH)的表达与尿毒症血液透析的发生发展之间的作用关系.方法 纳入尿毒症维持性血液透析患者96例,采用逆转录实时定量聚合酶链反应(RT-PCR)的方法对PTH的相对表达量进行检测,分析PTH的相对表达量与临床病理特征之间的相关性;应用Mann-whitney U检验法对患者PTH表达的高低与生存率之间的关系进行分析.结果 PTH相对表达量与患者的年龄、性别等并不存在相关性(P＞0.05);左心室舒张期内径(LVDd)、室间隔厚度(IVST)、左心室收缩期内径(LVDs)、左室质量指数(LVMI)、水肿、摄入量、血肌酐、收缩压升高与血清PTH水平呈正相关(P＜0.05);而左心射血分数(LVEF)、血红蛋白(Hb)、白蛋白(Alb)、Ca与血清PTH水平呈负相关(P＜0.05).42例PTH相对表达量明显下调的患者中并发糖尿病肾病的患者有18例(42.86％),而54例PTH高表达的患者并发糖尿病肾病仅有6例(11.11％),两组比较差异具有统计学意义,PTH表达的高低与并发糖尿病肾病着一定的相关性.结论 PTH相对表达量水平与并发糖尿病肾病及预后有相关性,PTH相对表达量作为尿毒症血液透析诊断和预后的新型标志物需要进一步的研究验证.