【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。更多还原

【Abstract】 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 Hct 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.更多还原