【摘要】 目的调查慢性肾脏疾病(CKD)继发性甲状旁腺功能亢进症(SHPT)的发病率,评价药物及手术治疗CKD继发SHPT的效果。方法回顾统计CKD导致SHPT的发病、治疗方法,比较治疗效果。结果本研究中CKD进入肾功能衰竭期,SHPT发病率为49%,大剂量间歇冲击方案服用活性维生素D 3个月,可使甲状旁腺素(PTH)降低50%以上,采用小剂量持续口服法PTH降低20%。甲状旁腺次全切除术(SPTX)复发率为12.9%,甲状旁腺全切术(TPTX)后低血钙发生率为54.5%。结论 CKD导致SHPT的发生较普遍,根据患者甲状旁腺素(PTH)水平应用不同剂量活性维生素D可有效降低PTH,难治性SHPT采用甲状旁腺切除术。更多还原

【Abstract】 Objective Summary standards for clinical treatment of secondary hyperparathyroidism(SHPT) caused by chronic kidney disease(CKD).Methods Compared the incidence of SHPT,different treatment.Results Till CKD stage 5,SHPT incidence is 49%.used high-dose active vitamin D three mouths,PTH can reduce more than 50%.Used low-dose,PTH decreased by 20%.SPTX recurrence rate was 12.9%,hypocalcaemia after TPTX was 54.5%.Conclusion CKD lead SHPT is more common,according to the patients parathyroid hormone(PTH) levels use different doses of active vitamin D can effectively reduce PTH,the therapy of refractory SHPT can choice TPTX.更多还原