终末期肾病患者行甲状旁腺切除对颈动脉钙化的影响

目的:探讨对终末期肾病患者行甲状旁腺切除对颈动脉钙化的影响.方法:选择我院2009年10月至2010年12月收治的20例继发性甲状旁腺功能亢进的终末期肾病患者,行甲状旁腺切除术,对患者术前、术后进行颈动脉彩超检查颈动脉钙化情况,并将患者术前、术后的血钙、血磷、钙磷乘积、PTH、C反应蛋白、血红蛋白、白蛋白等指标进行比较.结果:与术前比较,术后患者颈动脉钙化斑块有明显减少,血钙、血磷、钙磷乘积、PTH、C反应蛋白均明显降低,差异性有显著(P＜0.05)；血红蛋白较术前明显升高(P＜0.05).结论:切除甲状旁腺(PTX)能安全有效的降低甲状旁腺素水平、改善钙磷代谢紊乱,并控制颈动脉钙化的进展.

The Impact of Parathyroidectomy on Carotid Calcification for Patientswith End Stage Renal Disease (ESRD)*

Objective: To investigate the impact of parathyroidectomy on carotid calcification for patients with end stage renal dis-ease(ESRD),and to evaluate the effect of parathyroidectomy on carotid calcification,calcium and phosphate abnormality of end-stage renal disease patients.Methods: 20 parathyroid patients with ESRD of hyperparathyroidism from October,2010 to October,2011 in our hospital were excised and enrolled in this study.Carotid calcification was recorded before and after PTX.Meanwhile,the serum calcium,phosphorus,calcium-phosphate product,PTH,C-reactive protein,hemoglobin and albumin were compared before and after the surgery.Results: Compared with pre-operation,the serum calcium,phosphorus,calcium-phosphate product,PTH,C-reactive protein were signifi-cantly decreased in post-operation(P<0.05),and hemoglobin concentration was higher in post-operation than pre-operation(P<0.05).Conclusions: The removal of parathyroid glands(PTX) could rapidly and securely reduce the PTH,serum calcium levels and calci-um-phosphate product.It could prevent progression of vascular calcification and relieve the syndrome of patients with ESRD.