关键词: 血液透析, 甲状旁腺激素, 甲状旁腺体积

Abstract: Objective To investigate the incidence and risk factors of parathyroid gland enlargement in patients on maintenance hemodialysis.Methods A total of one hundred and seventy-six cases with uremia on maintenance hemodialysis were studied in terms of parathyroid gland size and bone metabolism index,such as serum intact parathyroid hormone(iPTH),calcium,phosphorus and alkaline phosphatase(ALP) etc.Results 1) According to the result of serum iPTH,176 patients with uremia on maintenance hemodialysis were divided into three groups:high-PTH group(serum iPTH>300 ng/L),there were 84 patients(47.7%),normal-PTH group(serum iPTH 150～300 ng/L),there were 32 patients(18.2%) and low-PTH group(serum iPTH<150 ng/L),there were 60 patients(34.1%).2) Among the total of 176 patients,60 patients(34.1%) suffered from parathyroid gland enlargement:48(57.1%) patients in high-PTH group,4 patients(12.5%) in normal-PTH group and 8(13.3%) in low-PTH group.The incidence and degree of parathyroid gland enlargement in high-PTH group were significantly higher than those in normal-PTH group and low-PTH group.3) Results of the univariate analysis and multivariate logistic regression analysis showed that the dialysis time,the usage of active vitamin D,serum phosphorus,serum calcium,serum ALP and the enlargement of hemofiltration were influencing factors for parathyroid gland enlargement in patients on maintenance hemodialysis.The dialysis time,unregular use of active vitamin D,serum phosphorus and ALP were positively correlated;the frequency of hemofiltration and serum calcium were negatively correlated with parathyroid gland enlargement.Conclusion The incidence of parathyroid gland enlargement is high in patients on maintenance hemodialysis.The duration of dialysis,the level of serum iPTH and the use of active vitamin D play a positive relation to parathyroid gland enlargement in patients with uremia on maintenance hemodialysis.

Key words: hemodialysis, parathyroid hormone, parathyroid gland enlargement