血液透析中超滤脱水对钙平衡的影响  

Influence of ultrafiltration on calcium balance during hemodialysis

作　　者：陈育青[1] 左力[1] 田爱辉[1] 王党龄 孙鲁英[1] 王梅[1] 

机构地区：[1]北京大学第一医院肾内科,100034 [2]河北省灞州市人民医院

出　　处：《临床内科杂志》2004年第11期739-740,共2页Journal of Clinical Internal Medicine

摘　　要：目的　观察在单次透析中 ,使用钙浓度为 1.5mmol/L的透析液透析时超滤脱水对钙平衡的影响。方法　维持性血液透析患者 18例 ,使用钙离子浓度为 1.5mmol/L透析液。按透析脱水量将患者分为 2组 ,每组 9例 ,A组脱水量 >2 .0kg ,B组不脱水。透析前后检测患者血清总钙浓度 ;透析前即刻取新鲜透析液并留取透析过程中全部废液 ,测总钙浓度。结果　A组与B组透析前血总钙水平在正常范围 ,且没有差异 ( 2 .3 3mmol/L± 0 .13mmol/LVs 2 .2 0mmol/L± 0 .14 3mmol/L ,P >0 .0 5 )。A组的废透析液的总钙浓度为 1.5 5mmol/L± 0 .0 5mmol/L ,较新鲜透析液 ( 1.5 0mmol/L± 0 .0 5mmol/L)升高 ,P <0 .0 5 ,提示存在钙的外流。而B组废透析液总钙浓度为 1.5 0mmol/L± 0 .0 3mmol/L ,较新鲜透析液 ( 1.5 3mmol/L± 0 .0 6mmol/L)下降 ,P >0 .0 5。结论　对于透析前血钙浓度正常的患者 ,单次透析中 ,使用钙浓度为 1.5mmol/L的透析液进行透析时 ,超滤脱水对钙平衡有影响 。Objective To assess the influence of ultrafiltration on total calcium (Ca) balance as using Ca 1.5 mmol/L dialysate during a single hemodialysis.Method Eighteen stable hemodialysis patients with normal serum calcium concentration in pre-dialysis were divided into two groups according to their ultrafiltration volume.Patients with ultrafiltration volume more than 2.0kg were as group A,patients without ultrafiltration were as group B.Total Ca concentrations of serum,fresh and spent dialysate were measured in pre- and post-dialysis respectively.Result There were no difference between two groups in serum Ca level in pre-dialysis (2.33± 0.13mmol/L & 2.20±0.143mmol/L,P>0.05).In group A, the total Ca concentration in spent dialysate was higher than that in fresh dialysate (P<0.05).While in group B the total Ca concentration in spent dialysate was a little bit lower than that in fresh dialysate (P>0.05).Conclusion For patients with normal serum Ca level in pre-dialysis,the ultrafiltration had significant influence on Ca balance. Large water removal resulted in a negative Ca balance,but in patients without ultrafiltration the Ca balance was positive.

关 键 词：血液透析 钙平衡 超滤脱水 

分 类 号：R459.5[医药卫生—治疗学]