Cov txiaj ntsig ntawm Kev Kho Mob Secondary Hyperparathyroidism

b. Kev kho mob phais

Qhov kev ntseeg siab tshaj plawsKev kho mob phais rau SHPTyog PTx, qhov kawg yuav tsum tau yog tias kev kho mob tsis ua tiav. Tom qab PTx, PTH txhim kho tau zoo heev. Postoperatively, raws li covtshaib plab pob txha syndrome txhim kho,hypocalcemia tshwm sim, thiabcalcium npajthiabvitamin D npajfeem ntau yuav tsum tau. Tom qab PTx, pob txha ceev txhim kho raws li cov pob txha metabolism txhim kho,

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Cov ntawv ceeb toom los ntawm Tebchaws MeskasLub raum Database System(USRDS) tau qhia tias nwstxo qhov kev pheej hmoo ntawm pob txha [23, 24].

Ib tsab ntawv ceeb toom los ntawm Nyij Pooj kuj pom tias thaum muab piv rau pawg PTx thiab cov pab pawg tsis yog Ptx hauv cov neeg mob uas muaj SHPT siab heev siv cov qhab nia sib tw,tag nrho kev tuagtus nqithiabmob plawvtus nqitau qis dua hauv pawg PTx. Nws tau pom tias muaj kev pheej hmoo ntawm kev tuag vimkab mob plawvyog txo los ntawm 34% thiab 41%, feem, piv rau pawg tsis yog Ptx [25]. Ib yam li ntawd, los ntawm USRDS cov ntaub ntawv, pawg PTx, pawg tsis yog Ptx

Ib daim ntawv qhia kev sib koom ua ke kuj tau qhia tias PTx txhim kho tag nrho kev tuag [26]. Tsis tas li ntawd, nws tau raug tshaj tawm tias PTx txhim kho LVH, txhim kho ntshav qab zib,txhim kho insomnia, itxhim kho kev paub txog kev ua haujlwm,txo cov kab mob peripheral artery(PAD), thiabtxo cov ntshav siab[27-31]. Tsis tas li ntawd, PTx yog kev kho mob nrog tus nqi zoo. Hais txog kev nyab xeeb ntawm PTx, tus neeg tuag nyob hauv 30 hnub tom qab PTx tau tshaj tawm tias yog 2.0-3.1% [26, 32].

c. Kev kho mob vs. kev kho mob phais

Ntxiv nrog rau cov kev kho mob ib txwm muaj, qhov tshwm sim ntawm calcimimetics xws li cinacalcet, ua raws li evocalcet, thiab etelcalcetide tau ua rau nws tsim nyog los hloov PTx, uas tau ua kev kho mob tseem ceeb txog thaum ntawd. Txawm hais tias tsis muaj cov ntaub ntawv ncaj qha sib piv cov txiaj ntsig ntawm calcimimetics thiab PTx ntawm kev tuag tag nrho, muaj ib qho kev tshuaj ntsuam xyuas piv rau kev kho mob nrog rau calcimimetics thiab PTx. Nws tau pom tias tag nrho cov neeg tuag thiab cov kab mob plawv tau txhim kho hauv pab pawg tau txais PTx piv rau kev kho mob [33, 34]. Tsis tas li ntawd, raws li kev tshuaj xyuas uas tau tshuaj xyuas qhov kev txhim kho ntawm QOL nrog cinacalcet thiab PTx hauv cov neeg mob nrog SHPT, qhov 36-khoom Cov txiaj ntsig Kev Kho Mob Kev Tshawb Fawb Txog Kev Noj Qab Haus Huv Short-Form (SF-36), PTx tau pom tias muaj txiaj ntsig zoo hauv kev txhim kho lub cev cov qhab nia thiab cov qhab nia ntawm lub hlwb. Ntawm qhov tod tes, cinacalcet pom tias tsis muaj kev txhim kho hauv lub cev cov qhab nia lossis cov qhab nia ntawm lub hlwb, qhia tias PTx tau zoo dua hauv kev txhim kho QOL [35]. Hais txog tus nqi-kev ua tau zoo, PTx tau hais tias yog qhov zoo tshaj rau cinacalcet [36, 37].

Xaus

Kev nce qib hauv kev kho mob, suav nrogcalciimetics, tau ua rau muaj kev hloov pauv hauv lubkev kho mob ntawm SHPTlos ntawm kev phais mus rau kev kho mob. Kev ua tau zoo ntawm kev kho mob kuj tau raug pov thawj, thiab nws yog qhov kev xaiv thawj zaug raukho SHPT. Txawm li cas los xij, yog tias kev kho mob tsis zoo lossis ua tsis tau, kev kho phais raug pom zoo kom sai. Rau yav tom ntej endocrine kws phais neeg, PTx rau SHPT tau dhau los ua kev phais uas tsis tshua muaj kev paub. Txawm li cas los xij, ntawm qhov tod tes, txawm hais tias muaj pes tsawg tus neeg uas xav tau PTx tsawg, nws xav tias yuav muaj xwm txheej yav tom ntej, thiab yog li ntawd PTx tau suav tias yog ib qho ntawm cov txheej txheem phais tseem ceeb rau cov kws phais endocrine. Kuv muaj hmoo txaus kom muaj ntau yam kev paub nrog PTx rau SHPT.

Cov kws phais neeg endocrine yuav tsum tsim cov txheej txheem phais, kev kuaj mob ua ntej, kev kuaj mob intraoperative, soj ntsuam xyuas, thiab lwm yam kom ntseeg tau PTx, thiab xa lawv mus rau lwm tiam neeg.

Siv:

1. Thaiv GA, Klassen PS, Lazarus JM, thiab al.: Mineral metabolism, morbidity, thiab morbidity hauv tu hemodialysis. J Am Soc Nephrol 15: 2208-2218, 2004

2. Slinin Y, Foley RN, Collins AJ: Calcium, phosphorus, para thyroid hormone, thiab kab mob plawv hauv cov neeg mob hemodialysis: USRDS waves 1, 3, thiab 4 txoj kev kawm. J Am

Soc Nephrol 16: 1788-1793, 2005

3. Danese MD, Kim J, Doan QV, et al.: PTH thiab cov kev pheej hmoo rau lub duav, vertebral, thiab pelvic fractures ntawm cov neeg mob ntawm kev lim ntshav. Am J Raum Dis 47: 149-156, 2006

4. Cov xwm txheej tam sim no ntawm PTx rau SHPT hauv PSSJ daim ntawv ntsuam xyuas 2019 http: //2hpt-japs.jp/pdf/genkyo_v210107.pdf Parathyroid hyperfunction

PTx Study Group (PSSJ) Working Group

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6. Fukagawa M, Fukuma S, Onishi Y, et al. : Daim Ntawv Qhia Cov Qauv thiab Cov Metabolism Tsis Txaus Ntsig hauv Cinacalcet Era : Cov txiaj ntsig tau los ntawm MBD-5D Kev Kawm. Clin J Am Soc Nephrol 7: 1473-1480, 2012

7. Komaba H, Nakanishi S, Fujimori A, et al.: Cinacalcet zoo txo ​​qis parathyroid hormone secretion thiab ntim tsis hais txog ntawm lub caj pas pretreatment loj rau cov neeg mob uas muaj theem nrab.hyperparathyroidism. Clin J Am Soc Nephrol 5: 2305-2314, 2010

8. Tatsumi R, Komaba H, Kanai G, thiab al.: Cinacalcet induces apoptosis nyob rau hauv parathyroid cells nyob rau hauv cov neeg mob uas muaj theem nrab hyperparathyroidism: histological thiab cytological tsom xam ses. Nephron Clin Pract 124: 224-231, 2013

9. Behets GJ, Spasovski G, Sterling LR, thiab al.: Pob txhacov neeg siv khoom photometry ua ntej thiab tom qab kev kho mob ntev nrog cinacalcet hauv cov neeg mob dialysis nrog cov hyperparathyroidism theem nrab. Raum Int 87: 846-856, 2015

10. Moe SM, Abdalla S, Chertow GM, et al.: Cov teebmeem ntawm Cina calcite ntawm Fracture Events in Patients ReceivinHemodialysiss : The EVOLVE Trial. J Am Soc Nephrol 26: 1466-

1475, 2015