内科

目的探讨甲状旁腺激素（PTH）水平对血液透析患者心理状态与生活质量的影响。方法选取在本院血液净化中心行维持性血液透析（MHD）治疗3个月以上的患者102例作为研究对象。分析患者PTH水平与血钙、血磷、钙磷乘积、血红蛋白、血清铁蛋白、透析月数、月透析次数及年龄的关系；通过问卷调查评定患者的心理状态与生活质量，分析PTH水平对血液透析患者心理状态与生活质量的影响。结果MHD患者PTH水平与血磷、钙磷乘积及透析月数呈正相关（r=0.336，P=0.001；r=0.291，P=0.004；r=0.235，P=0.021），与患者年龄呈负相（r=-0.228，P=0.021）。MHD患者PTH水平与HAMA、HAMD量表得分呈正相关（r=0.384，P=0.000；r=0.381，P=0.000）；与SF-36量表的躯体健康总评（PCS）、情感职能（RE）、心理健康（MH）及精神健康（MCS）得分呈负相关（r=-0.210，P=0.040；r=-0.326，P=0.001；r=-0.223，P=0.029；r=-0.315，P=0.002）。结论低龄、高磷血症、高钙磷乘积、透析龄长可能是MHD患者PTH水平升高的危险因素；患者PTH水平升高，焦虑和抑郁的发生率随之升高、生活质量下降。

ObjectiveTo analyze the effect of parathyroid hormone (PHT) on the quality of life and mental status in patients with hemodialysis. MethodsA total of 102 patients who underwent maintenance hemodialysis（MHD） for 3 months in our blood purification center were enrolled. The relationship between PTH and age, dialysis status, calcium, phosphorus, calcium-phosphorus product, hemoglobin, serum ferritin was analyzed; the questionnaire was used to evaluate the quality of life and mental status, and the effect of PHT on the quality of life and mental status was also analyzed. ResultsPTH had positive correlation with phosphorus, calcium-phosphorus product, months of dialysis, scores of HAMA and HAMD (r=0.336，P=0.001；r=0.291，P=0.004；r=0.235，P=0.021; r=0.384，P=0.000；r=0.381，P=0.000), and had negative correlation with PCS, RE, MH and MCS (r=-0.210，P=0.040；r=-0.326，P=0.001；r=-0.223，P=0.029; r=-0.31，P=0.002). ConclusionsYoung, hyperphosphatemia, high calcium-phosphorus product and long age of dialysis may be the risk factors of increased PTH in patients with hemodialysis; patients with high levels of PTH have higher incidence of mental disorders, and lower quality of life.