【摘要】：目的:探討腎移植術(shù)后1年內(nèi)高鈣血癥的發(fā)生率及危險(xiǎn)因素,并觀察血清鈣的演變特點(diǎn)。方法:選取從2013年11月至2015年3月在南京軍區(qū)南京總醫(yī)院腎臟科行腎移植手術(shù)的受者115例,分別于腎移植術(shù)前、術(shù)后1個(gè)月、3個(gè)月、6個(gè)月、12個(gè)月檢測(cè)血清鈣、全段甲狀旁腺激素(iPTH)等礦物質(zhì)和骨代謝指標(biāo)。結(jié)果:腎移植術(shù)后受者血清鈣逐步升高,高鈣血癥的發(fā)生率在術(shù)后3個(gè)月時(shí)達(dá)到最高值42.6%,隨后逐步下降,至術(shù)后12個(gè)月時(shí)為39.1%。患者所有隨訪時(shí)間點(diǎn)的血清鈣均3.0 mmol/L。多因素線性回歸分析顯示術(shù)前高iPTH、術(shù)后6個(gè)月時(shí)低磷血癥和高堿性磷酸酶是術(shù)后6個(gè)月時(shí)高鈣血癥的危險(xiǎn)因素,術(shù)前透析時(shí)間長(zhǎng)和術(shù)前高iPTH是術(shù)后12個(gè)月時(shí)發(fā)生高鈣血癥的危險(xiǎn)因素。結(jié)論:腎移植術(shù)后1年內(nèi)30%~40%的受者可出現(xiàn)高鈣血癥。術(shù)前高iPTH是術(shù)后6個(gè)月和12個(gè)月時(shí)高鈣血癥的危險(xiǎn)因素。監(jiān)控術(shù)前iPTH有助于術(shù)后高鈣血癥的預(yù)防和治療。
[Abstract]:Objective: to investigate the incidence and risk factors of hypercalcemia in one year after renal transplantation, and to observe the evolution of serum calcium. Methods: from November 2013 to March 2015, 115 patients underwent renal transplantation in the Department of Kidney of Nanjing military region General Hospital of Nanjing military region. Serum calcium levels were measured at 1 month, 3 months, 6 months and 12 months after renal transplantation, respectively. Total parathyroid hormone (iPTH) and other mineral and bone metabolism indicators. Results: the level of serum calcium increased gradually after renal transplantation, and the incidence of hypercalcinemia reached the highest value of 42.6 at 3 months after transplantation, then decreased gradually, and was 39.1 at 12 months after transplantation. Serum calcium levels at all follow-up time points were 3.0 mmol/L. Multivariate linear regression analysis showed that hypophosphatemia and hyperalkaline phosphatase were the risk factors of hypercalcemia at 6 months postoperatively with high iPTH,. Long duration of preoperative dialysis and preoperative high iPTH were risk factors of hypercalcemia 12 months after operation. Conclusion: 30% of recipients have hypercalcemia within 1 year after renal transplantation. Preoperative high iPTH was a risk factor for hypercalcemia at 6 and 12 months postoperatively. Monitoring preoperative iPTH is helpful for the prevention and treatment of postoperative hypercalcemia.
【作者單位】： 第二軍醫(yī)大學(xué)金陵醫(yī)院(南京軍區(qū)南京總醫(yī)院)腎臟科國家腎臟疾病臨床醫(yī)學(xué)研究中心全軍腎臟病研究所;
【基金】：國家科技支撐計(jì)劃課題(2015BAI12B02,2015BAI12B05) 江蘇省科技計(jì)劃項(xiàng)目(BE2016747)
【分類號(hào)】：R699.2

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