摘要
Abstract
Objective:To analyze the changes of postoperative calcium-phosphorus metabolism and the risk factors of cardiovascular adverse events in hemodialysis patients with secondary hyperparathyroidism undergoing total parathyroidectomy.Method:The data of 80 hemodialysis patients with secondary hyperparathyroidism in Nanchang First Hospital were selected from January 2020 to August 2022.All patients were treated with total parathyroidectomy.The changes in calcium-phosphorus metabolism indicators[intact parathyroid hormone(iPTH),serum calcium(Ca),serum phosphorus(P)]were compared before surgery and at 1 month and 1 year after surgery.According to the occurrence of adverse cardiovascular events within 1 year after surgery,they were classified into good group and abnormal group.The clinical data of the two groups were compared,and logistic regression analysis was performed on the single factors with differences.Result:The iPTH,Ca and P of patients before surgery and at 1 month and 1 year after surgery showed downward trends(P<0.05),and the above indicators at 1 month and 1 year after surgery were lower than those before surgery(P<0.05).There were 22 patients with cardiovascular adverse events within 1 year after surgery,with an incidence rate of 27.50%.The age and dialysis age in abnormal group were older than those in good group,and the preoperative iPTH,Ca,P,systolic blood pressure and low-density lipoprotein cholesterol were higher than those in good group(P<0.05).logistic regression analysis showed that dialysis age,preoperative iPTH,systolic blood pressure and low-density lipoprotein cholesterol were risk factors of cardiovascular adverse events(P<0.05).Conclusion:The calcium-phosphorus metabolism function of hemodialysis patients with secondary hyperparathyroidism after total parathyroidectomy is significantly improved.Dialysis age,preoperative iPTH,systolic blood pressure,and low-density lipoprotein cholesterol were the influencing factors of postoperative cardiovascular adverse events.Clinically,it is necessary to perform regular monitoring for patients with the above conditions to ensure good prognosis.关键词
血液透析继发性甲状旁腺功能亢进/甲状旁腺全切术/钙磷代谢/心血管不良事件/影响因素Key words
Hemodialysis secondary hyperparathyroidism/Total parathyroidectomy/Calcium-phosphorus metabolism/Cardiovascular adverse events/Influencing factors
