目的 分析2型糖尿病肾衰竭继发性甲状旁腺功能亢进的相关因素.方法 选取该院收治的110例2型糖尿病肾衰竭患者作为研究对象,所有患者均经过影像学检测以及实验室诊断为2型糖尿病肾衰竭,病情稳定且未进行甲状旁腺手术治疗,分析其临床资料以及相关实验室指标,比较不同甲状旁腺激素(P T H)水平的患者临床表现及实验室检测差异,采用单因素及多因素分析方法探讨影响2型糖尿病肾衰竭继发性甲状旁腺功能亢进患者的危险因素.结果 110例患者根据甲状旁腺激素水平将其分为低PT H组61例(PT H<300 pg/mL)及高PT H组49例(PT H≥300 pg/mL),根据患者的一般资料并采用单因素分析发现,高血压、年龄、肌酐、脉压、透析时间、三酰甘油和C-反应蛋白、血磷水平是影响继发性甲状旁腺功能亢进的危险因素;多因素分析发现,高血压、透析时间、C-反应蛋白和血磷水平升高则是对SHPT造成影响的独立危险因素,其中高血压与SHPT呈负相关.结论 高血压、透析时间、C-反应蛋白和血磷水平升高是诱发甲状旁腺功能亢进的独立危险因素,对继发性甲状旁腺功能亢进进行早期诊治能够有效延缓慢性肾衰竭的进行性发展.%Objective To analyze the related factors of secondary hyperparathyroidism (SHPT ) in type 2 diabetes mellitus (T2DM ) patients with renal failure .Methods One hundred and ten T2DM patients with renal failure treated in our hospital were selected as the study subjects .All cases were diagnosed as renal failure by the imaging examination and laboratory detections .The disease condition was stable without the parathyroid operation treatment .Their clinical data and related laboratory indicators were analyzed .The differences in clinical manifestations and laboratory detection were compared among the patients with different para-thyroid hormone(PTH) levels .The univariate and multivariate analysis method was adopted to analyze the risk factors affecting T2DM renal failure patients with SHPT .Results One hundred and ten patients were divided into the low PTH group (61 cases , PTH<300 pg/mL) and high PTH group(49 cases ,PTH≥300 pg/mL) according to PTH level ;according to the patient′s general data ,adopting the single factor analysis found that hypertension ,age ,creatinine level ,pulse pressure ,dialysis duration ,triglyceride , C-reactive protein and serum phosphorus level arise were the risk factors of secondary hyperparathyroidism ,in which hypertension was negatively correlated with SHPT .Conclusion Hypertension ,dialysis duration ,C-reactive protein and serum phosphorus level are the independent risk factors inducing SHPT .Early diagnosis and treatment of SHPT can effectively delay the progressive devel-opment of chronic renal failure .
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