甲状旁腺切除术对继发性甲状旁腺功能亢进血液透析患者骨代谢的影响。
Effects of parathyroidectomy on bone metabolism in haemodialysis patients with secondary hyperparathyroidism.
作者信息
Ma Lijie, Zhao Sumei, Li Zhongxin
机构信息
a Department of Nephrology , Beijing Chaoyang Hospital, Capital Medical University , Beijing , China.
b Department of Nephrology , Beijing Lu He Hospital, Capital Medical University , Beijing , China.
出版信息
Scand J Clin Lab Invest. 2017 Nov;77(7):527-534. doi: 10.1080/00365513.2017.1354256. Epub 2017 Jul 25.
OBJECTIVE
To evaluate the outcome of bone metabolism and bone mineral density (BMD) in haemodialysis patients after parathyroidectomy (PTX).
METHODS
A total of 31 haemodialysis patients with secondary hyperparathyroidism (SHPT) were treated with PTX. BMD of lumbar spine (LS) and femoral neck (FN) was determined by dual energy X-ray absorptiometry.
RESULTS
Parathyroidectomy ledds to significant decrease of serum β-crosslaps (β-CTX), osteocalcin (OC) and procollagen type I amino-terminal propeptide (PINP) while serum sclerostin (SOST) increased after surgery. BMD was markedly improved in both LS and FN after PTX. Z-scores analysis further confirmed that PTX significantly benefited bone metabolism in haemodialysis patients, which well correlated with the improvement of serum iPTH and OC.
CONCLUSIONS
Parathyroidectomy leads to significant improvement of serum OC, PINP, β-CTX and SOST, which may beneficially modify calcium-phosphorus metabolism and BMD in haemodialysis patients with SHPT.
目的
评估甲状旁腺切除术后（PTX）血液透析患者的骨代谢及骨密度（BMD）结果。
方法
共31例继发性甲状旁腺功能亢进（SHPT）血液透析患者接受了PTX治疗。采用双能X线吸收法测定腰椎（LS）和股骨颈（FN）的骨密度。
结果
甲状旁腺切除术后血清β-交联C端肽（β-CTX）、骨钙素（OC）和I型前胶原氨基端前肽（PINP）显著降低，而血清硬化蛋白（SOST）升高。PTX术后LS和FN的骨密度均显著改善。Z评分分析进一步证实，PTX显著改善了血液透析患者的骨代谢，这与血清全段甲状旁腺激素（iPTH）和OC的改善密切相关。
结论
甲状旁腺切除术可显著改善血清OC、PINP、β-CTX和SOST，这可能有益地改善SHPT血液透析患者的钙磷代谢和骨密度。
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