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甲状旁腺切除术可改善肾性贫血
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Parathyroidectomy Ameliorates Renal Anemia NEW YORK (Reuters Health) Jul 20 - Surgical removal of the parathyroid glands controls secondary hyperparathyroidism in patients with chronic renal failure, a Chinese research team reports. Their retrospective cohort study, reported in the Archives of Surgery for July, also shows that the surgery increases hemoglobin level. Other studies have demonstrated relatively little effect of parathyroidectomy on anemia in patients with chronic renal failure. Senior investigator Dr. Siu-Ho Lam and associates at United Christian Hospital in Hong Kong point out that the results may be more applicable to a relatively homogeneous cohort of Chinese patients with chronic renal failure and severe hyperparathyroidism. Their 23 patients, ages 25 to 66 years, had chronic renal failure due to a number of causes and were undergoing dialysis. Indications for parathyroidectomy included renal osteodystrophy, pruritus, muscle weakness, bone fracture, and ectopic calcification. Mean hemoglobin levels rose significantly from 8.6 g/dL prior to surgery to 9.4 g/dL after surgery, although platelet count remained unchanged. Levels of parathyroid hormone, alkaline phosphatase, calcium, phosphate and albumin all "improved remarkably after surgery," Dr. Lam's group reports. They recognize that more trials will be necessary to corroborate long-term effects. They add, however, that "if proved, renal anemia might be considered as a new indication for parathyroidectomy in patients undergoing long-term dialysis. Arch Surg 2007;142:644-648 甲状旁腺切除术可改善肾性贫血 纽约（路透社健康专栏）7月20日——中国研究人员进行的一项回顾性队列研究显示，手术切除甲状旁腺不仅能控制慢性肾功能衰竭患者的继发性甲状旁腺功能亢进症，还能提高此类患者的血红蛋白水平。研究结果发表在《the Archives of Surgery》7月刊。（Arch Surg 2007;142:644-648） 资深研究员Siu-Ho Lam和香港基督教联合医院的同事们指出，曾有研究证实，甲状旁腺切除术对慢性肾功能衰竭患者的贫血有轻度影响，但这个结果可能更适用于相对同质的中国患者。 Lam博士的研究小组对23名各种原因引起的慢性肾功能衰竭患者进行研究，这些患者的年龄为25～66岁，且都在接受透析治疗。甲状旁腺切除术的适应症包括肾病性骨营养不良、瘙痒症、肌无力、骨折和异位钙化。结果显示，虽然血小板数量无明显变化，但平均血红蛋白水平显著增加，从术前的8.6 g/dL增加到术后的9.4 g/dL。此外，手术后甲状旁腺素、碱性磷酸酶、钙、磷和白蛋白水平都有显著改善。 研究人员坦言，目前还需要更多的试验来证实甲状旁腺切除术的长期效应。但是，他们补充说，“如果结果得到证实，肾性贫血则可能成为长期透析患者进行甲状旁腺切除术的一个新的适应症。” [ Last edited by yjlxn on 2007-7-24 at 19:22 ] |
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