甲状旁腺全切除加前臂移植术治疗对尿毒症继发性甲状旁腺功能亢进成纤维生长因子23及骨代谢观察(1)
【摘要】 目的：探討甲状旁腺全切并自体前臂移植术(PTX+AT)对尿毒症继发性甲状旁腺功能亢进(SHPT)成纤维生长因子23(FGF23)及骨代谢影响。方法：选取2014年4月-2016年12月本院尿毒症合SHPT接受PTX+AT的患者25例。比较手术前后的血肌酐、尿酸、血红蛋白、白蛋白、血清FGF23、钙、磷、甲状旁腺激素(PTH)及碱性磷酸酶(ALP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)、血清总Ⅰ型胶原氨基端延长肽(TP1NP)及生活质量评分(SF-36)。结果：术前SF-36评分低于术后
6个月(P<0.05)；患者术前及术后3、6个月的血肌酐、血尿酸及血红蛋白、血白蛋白比较，差异均无统计学意义(P>0.05)；术后3、6个月，血钙、磷、ALP、TP1NP、β-CTX、PTH、FGF23水平均低于术前，比较差异均有统计学意义(P<0.05)；术后6个月，血磷、PTH、FGF23水平均高于术后3个月，但比较差异均无统计学意义(P>0.05)。结论：PTX+AT治疗尿毒症合SHPT能改善患者生活质量，纠正钙磷代谢紊乱，改善骨代谢。
, http://www.100md.com
【关键词】 继发性甲状旁腺功能亢进； 甲状旁腺切除术； 前臂移植； 纤维生长因子23； 骨代谢
Effects of Total Parathyroidectomy with Auto Transplantation on Fibroblast Growth Factor 23 and Bone Metabolism in Uremic Patients with Secondary Hyperparathyroidism/LIANG Zijie，HOU Aizhen，XIAO Guanqing，et al.//Medical Innovation of China，2018，15(19)：0-015
【Abstract】 Objective：To observe the effects of total parathyroidectomy with auto transplantation(PTX+AT) on fibroblast growth factor 23(FGF23) and bone metabolism in uremic patients with secondary hyperparathyroidism(SHPT).Method：A total of 25 patients with uremia with SHPT received PTX+AT in our hospital from April 2014 to December 2016 were selected.The levels of serum creatinine，uric acid，hemoglobin，albumin，FGF23，calcium，phosphorus，parathyroid hormone (PTH)，alkaline phosphatase(ALP)，type Ⅰ collagen carboxyl terminated peptide beta specific sequence(β-CTX)，serum total typeⅠcollagen amino end lengthening peptide(TP1NP)，quality of life score(SF-36) before and after operation were compared.Result：The SF-36 score before operation was lower than that of after operation6 months(P<0.05).The levels of serum creatinine，uric acid，hemoglobin，albumin before and after operation 3 and 6 months were compared，the differences were not statistically significant(P>0.05). After operation 3 and 6 months，the levels of serum calcium，phosphorus，ALP，TP1NP，β-CTX，PTH and FGF23 were all lower than those of before operation，the differences were statistically significant(P<0.05).After 6 months，the levels of phosphorus，PTH and FGF23 were all higher than those of after operation 3 months，but the differences were not statistically significant(P>0.05).Conclusion：PTX+AT treatment of uremia with SHPT can improve the quality of life of patients，correct the disorder of calcium and phosphorus metabolism，and improve bone metabolism.
【Key words】 SHPT； Total parathyroidectomy； Forearm transplantation； FGF23； Bone metabolism
First-author’s address：The First People’s Hospital of Foshan City，Foshan 528000，China, 百拇医药(梁子介 侯爱珍 肖观清)
6个月(P<0.05)；患者术前及术后3、6个月的血肌酐、血尿酸及血红蛋白、血白蛋白比较，差异均无统计学意义(P>0.05)；术后3、6个月，血钙、磷、ALP、TP1NP、β-CTX、PTH、FGF23水平均低于术前，比较差异均有统计学意义(P<0.05)；术后6个月，血磷、PTH、FGF23水平均高于术后3个月，但比较差异均无统计学意义(P>0.05)。结论：PTX+AT治疗尿毒症合SHPT能改善患者生活质量，纠正钙磷代谢紊乱，改善骨代谢。
, http://www.100md.com
【关键词】 继发性甲状旁腺功能亢进； 甲状旁腺切除术； 前臂移植； 纤维生长因子23； 骨代谢
Effects of Total Parathyroidectomy with Auto Transplantation on Fibroblast Growth Factor 23 and Bone Metabolism in Uremic Patients with Secondary Hyperparathyroidism/LIANG Zijie，HOU Aizhen，XIAO Guanqing，et al.//Medical Innovation of China，2018，15(19)：0-015
【Abstract】 Objective：To observe the effects of total parathyroidectomy with auto transplantation(PTX+AT) on fibroblast growth factor 23(FGF23) and bone metabolism in uremic patients with secondary hyperparathyroidism(SHPT).Method：A total of 25 patients with uremia with SHPT received PTX+AT in our hospital from April 2014 to December 2016 were selected.The levels of serum creatinine，uric acid，hemoglobin，albumin，FGF23，calcium，phosphorus，parathyroid hormone (PTH)，alkaline phosphatase(ALP)，type Ⅰ collagen carboxyl terminated peptide beta specific sequence(β-CTX)，serum total typeⅠcollagen amino end lengthening peptide(TP1NP)，quality of life score(SF-36) before and after operation were compared.Result：The SF-36 score before operation was lower than that of after operation6 months(P<0.05).The levels of serum creatinine，uric acid，hemoglobin，albumin before and after operation 3 and 6 months were compared，the differences were not statistically significant(P>0.05). After operation 3 and 6 months，the levels of serum calcium，phosphorus，ALP，TP1NP，β-CTX，PTH and FGF23 were all lower than those of before operation，the differences were statistically significant(P<0.05).After 6 months，the levels of phosphorus，PTH and FGF23 were all higher than those of after operation 3 months，but the differences were not statistically significant(P>0.05).Conclusion：PTX+AT treatment of uremia with SHPT can improve the quality of life of patients，correct the disorder of calcium and phosphorus metabolism，and improve bone metabolism.
【Key words】 SHPT； Total parathyroidectomy； Forearm transplantation； FGF23； Bone metabolism
First-author’s address：The First People’s Hospital of Foshan City，Foshan 528000，China, 百拇医药(梁子介 侯爱珍 肖观清)