科会肾内甲旁亢课件.pptx

1、This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller a

2、nd DS18B20 temperature sensor.CKD-MBDCKD-MBDThis paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components

3、 of the system are AT89C51 microcontroller and DS18B20 temperature sensor.Zhang L,Wang F,Wang L,et al.Lancet.2012 Mar 3;379(9818):815-22.我国我国CKD患者众多，以早中期为主患者众多，以早中期为主我国CKD患者数量近1.2亿CKD4-5*一项大型研究，从中国不同的13个省份中选取47204名受访者，其中CKD患者比例为10.8%。This paper mainly introduces the design of an intelligent temperat

4、ure control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.CKD-MBD定义及诊断 自2005年KDIGO建议将以往的“肾性骨病”

5、及“肾性骨营养不良”范畴扩大为“慢性肾脏病（CKD）相关性矿物质及骨代谢紊乱（CKD-MBD）”，CKD-MBD已成为当前全球肾脏病界关注及研究的热点1。1.卜磊,et al.,Chin J Nephrol,2010,26(1).2.Kidney International.2009),76(Suppl 113),:S3-S8.CKD-MB）是一全身性疾病，常具有下列一个或一个以上表现：钙、磷、PTH或维生素D代谢异常 骨转化、矿化、骨容量、骨骼线性生长或骨强度的异常 血管或其它软组织钙化 This paper mainly introduces the design of an intell

6、igent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.中国血液净化2012年7月第11卷第7期,3

7、60-363早中期早中期CKD患者已有较高比例患者已有较高比例发生低钙高磷和继发甲旁亢发生低钙高磷和继发甲旁亢CKD3-5期透析前患者矿物质及骨代谢紊乱的调查分析22.2%15.6%47.6%29.4%56.8%56.8%68.3%76.0%80.4%0%20%40%60%80%100%低钙血症高磷血症SHPTCKD 3期CKD 4期 CKD 5期 CKD3-5期透析前患者矿物质及骨代谢紊乱的调查期透析前患者矿物质及骨代谢紊乱的调查分析分析This paper mainly introduces the design of an intelligent temperature control

8、system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.PTH升高会作用于骨，影响骨骼健康升高会作用于骨，影响骨骼健康 过高浓度的过高浓度的PTH使破骨

9、细胞活性超过成骨细胞，导致使破骨细胞活性超过成骨细胞，导致溶骨超过成骨，从而产生一系列骨骼病变溶骨超过成骨，从而产生一系列骨骼病变 甲旁甲旁亢的骨骼系统影像学改变主要是破骨活动增强，亢的骨骼系统影像学改变主要是破骨活动增强，同时伴有新骨形成，但类骨组织钙化不足，最终导致同时伴有新骨形成，但类骨组织钙化不足，最终导致骨量减少、骨吸收及纤维囊性骨炎等表现骨量减少、骨吸收及纤维囊性骨炎等表现 PTH水平与骨密度呈显著负相关水平与骨密度呈显著负相关杨敏星等，中华全科医师杂志，2014 Vol 13,No.5,351-353郁胜强等，中国全科医学，2013 Vol 16，No.10B,3422-3424

10、This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller a

11、nd DS18B20 temperature sensor.1/22/2023骨质疏松This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components

12、of the system are AT89C51 microcontroller and DS18B20 temperature sensor.1/22/2023甲旁亢时骨膜下骨吸收/侵蚀This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B2

13、0 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.1/22/2023头颅骨板樟增厚 背景“盐和胡椒”或“虫蛀”样现象This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement an

14、d control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.1/22/2023Sagliker Syndrome:Uglifying Human Face Appearance in Late and Severe Secondary Hyperparathyroidism in C

15、hronic Renal FailureThis paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C

16、51 microcontroller and DS18B20 temperature sensor.1/22/2023This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The

17、core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.Glen T.Schumock,Dennis L.Andress,Steven E.Marx,et al.Nephron Clin Pract 2009;113:c54c61SHPT也显著增加也显著增加CKD进展和死亡风险进展和死亡风险透析/死亡风险：HR=5.2HR=5.2（P0.0001 P0.0001）透析风险：HR=HR=6.76.7（P0.0001P30eGFR 30的CKDCKD患者，n=3949n=394

18、9早中期早中期CKD患者，钙摄入和血钙患者，钙摄入和血钙与与iPTH70pg/ml的的发生率呈显著负相关发生率呈显著负相关 钙摄入量越高，同时补充VD患者，iPTH水平较低 血清钙水平越高，iPTH平均值越低，iPTH 大于70pg/ml的患者比例越小P P-trend 0.001-trend 0.001P P-trend 0.001-trend 0.001元素钙摄入（mg/日）血钙水平（mg/dL）P P-trend 0.001-trend 0.001 iPTH70pg/ml的发生率 iPTH70pg/ml的发生率This paper mainly introduces the design

19、 of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.研究发现：大剂量碳

20、酸钙研究发现：大剂量碳酸钙+低剂量骨化三醇低剂量骨化三醇可显著纠正早期可显著纠正早期CKD患者的生化指标异常患者的生化指标异常Bianchi ML,Colantonio G,Campanini F,et al.Nephrol Dial Transplant.1994;9(11):1595-9.一项回顾性研究，纳入17位患者，随访30个月：0-6进行观察，6-30月进行24个月的1000mg碳酸钙和0.25ug骨化三醇联合治疗，旨在观察疗效10914292.481.6607080901001101201301401500612182430P P 0.050.05(随访单位：月)观察期治疗期 PT

21、H水平 pg/mlThis paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcon

22、troller and DS18B20 temperature sensor.Praveen Kandula,et al.Clin J Am Soc Nephrol.2011 January;6(1):5062.普通维生素D可以显著降低CKD患者PTH水平研究维生素D D剂量平均差异普通VD VS VD VS 对照组Chandra 200850,000 IU，1次/周-76.00(-259.94，107.94)Dogan 2008300,000 IU，1次-9.00(-124.69,106.69)Siebert 2007未说明-5.10(-85.60,75.40)Wissing 200525,

23、000 IU/月，同时补充Ca-35.00(-62.94,-7.06)整体差异-31.53(-57.01,-6.05)平均差异-100 -50 0 50 100 维生素D组安慰剂/未治疗组31.5pg/mlP=0.02普通维生素D使PTH水平降低检索MEDLINE（1966年至2009年9月），SCOPUS（1980至2009年9月），以及肾病学大会中的随机对照和观察性研究数据（排除活性维生素D的临床研究），荟萃分析评价非透析CKD患者/透析患者/肾移植患者补充维生素D的获益和风险，对照组为安慰剂或为治疗组。This paper mainly introduces the design of

24、an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.Kooienga L,Fr

25、ied L,Scragg R,et al.Am J Kidney Dis.2009 Mar;53(3):408-16.CaD有助控制有助控制CKD患者患者PTH水平在正常范围水平在正常范围eGFR60 mL/min/1.73 meGFR60 mL/min/1.73 m2 2iPTH iPTH 目标60 pg/mL60 pg/mLeGFR 45-59 mL/min/1.73 m2eGFR 45-59 mL/min/1.73 m2iPTH iPTH 目标 35-70 pg/mL 35-70 pg/mLeGFR 45 mL/min/1.73 m2eGFR 45 mL/min/1.73 m2iPTH

26、iPTH 目标 35-70 pg/mL 35-70 pg/mL（CKD3CKD3期）iPTH iPTH 目标 70-110 pg/mL 70-110 pg/mL（CKD4CKD4期）多中心、随机、双盲、安慰剂对照研究，入选639例老年CKD伴继发性甲状旁腺功能亢进的女性患者，接受 1200mg 钙和 800IU 维生素D复合制剂、钙剂1200mg及维生素D 800IU、或安慰剂治疗，评价对血全段甲状旁腺激素（iPTH）的影响。对照组和治疗组iPTH水平有显著差异，p=0.02iPTH（pg/mL）iPTH（pg/mL）iPTH（pg/mL）时间（月）时间（月）时间（月）安慰剂安慰剂安慰剂Ca

27、剂+VD制剂CaD复合制剂Ca 剂+VD制剂CaD复合制剂Ca 剂+VD制剂CaD复合制剂This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core component

28、s of the system are AT89C51 microcontroller and DS18B20 temperature sensor.钙尔奇钙尔奇：单片元素钙含量单片元素钙含量最高最高，疗效更好疗效更好不同钙补充剂的元素钙含量600mg500mg300mg200mg0100200300400500600700钙尔奇D普通碳酸钙D3片 碳酸钙D3颗粒醋酸钙元素钙含量，mgThis paper mainly introduces the design of an intelligent temperature control system which realizes the fu

29、nction of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.钙尔奇钙尔奇 -含含维生素维生素D的钙片的钙片 钙尔奇每片含125IU 维生素D，促进钙吸收及其在骨质中的沉积This paper mainly int

30、roduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperatur

31、e sensor.钙尔奇钙尔奇：微囊专利技术，稳定更安全：微囊专利技术，稳定更安全商品名商品名通用名通用名剂型剂型元素钙含量元素钙含量保质期保质期保存温度限制保存温度限制钙尔奇 碳酸钙D3片片剂600mg36个月无普通碳酸钙D3碳酸钙D3片咀嚼片500mg24个月25以下符合美国FDA六大质量体系的和27个质量要素，确保质量卓越This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measure

32、ment and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.总结 CKD早中期患者发生继发甲旁亢比例早中期患者发生继发甲旁亢比例高，高，提示应提示应尽早干预尽早干预 PTH水平升高与骨密度显著负相关；水平升高与骨密度显著负相关；SHPT增加增加CKD进展和死亡风险进展和

33、死亡风险 CaD有助控制有助控制PTH水平，从而预防继发甲旁亢导致水平，从而预防继发甲旁亢导致的继发性骨质疏松的继发性骨质疏松This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.Thanks!