透析液钙离子浓度对肾功能衰竭血液透析患者血清钙离子水平及血压的影响  

Effects of calcium concentration in dialysate on serum calcium concentration and blood pressure of patients with renal failure

作　　者：张增政[1] 高妍婷[1] 王晓玲[1] 强华[1] 

机构地区：[1]陕西省人民医院透析中心,陕西西安710068

出　　处：《现代泌尿外科杂志》2006年第4期209-211,共3页Journal of Modern Urology

摘　　要：目的观察不同钙离子浓度的透析液对血液透析患者透析后血清钙离子水平及血压变化的影响,为肾功能衰竭血液透析患者的高钙血症及高血压的防治提供依据。方法选择不同钙离子浓度的透析液,将维持性血液透析患者分为高钙组(1.75mmol/L)和低钙组(1.25 mmol/L),比较患者每次透析前后脉搏、血压,同时抽查患者透析前后血钙及血肌酐浓度的变化。结果透析后两组患者血肌酐浓度均显著下降,透析前后差异均具有统计学意义(P<0.01);高钙组患者透析后血钙较透析前升高,差异具有统计学意义(P<0.01),而低钙组患者血钙比透析前略降低,差异无统计学意义(P>0.05)。高钙组患者透析后较透析前收缩压、舒张压及平均动脉压都升高,差异均具有统计学意义(P<0.05),而低钙组患者透析后较透析前收缩压、舒张压及平均动脉压都降低,差异均具有统计学意义(P<0.05)。透析后两组血钙比较差异具有统计学意义(P<0.01);透析后低钙组较高钙组患者的收缩压、舒张压及平均动脉压都降低,三者差异均具有统计学意义(P<0.01)。结论透析液钙离子浓度与血液透析患者血清钙离子水平及血压呈正相关,低钙透析液透析有助于维持性血液透析患者高血压的控制。Objective To provide a theoretical basis for the prevention and treatment of hypercalcinemia and hypertension of patients with uremia, by investigating the influence of calcium concentration in dialysate on serum calcium level and blood pressure in patients with renal failure. Methods 118 cases were randomly divided into two groups. High calcium dialysate（1.75 mmol/L） and low calcium dialysate （1.25 mmol/L） were used during hemodialysis. Serum calcium, serum creatinine and blood pressure were determined and analyzed before and aftereach dialysis. Results Serum creatinine declined significantly in both groups after hemodialysis; While serum calcium concentration significantly increased after dialysis in the high calcium group（P〈 0.01）, but did not change much in the low calcium group （P〉0.05）. Systolic pressure, diastolic pressure and mean arterial pressure increased significantly in the high calcium group after dialysis（P〈0.05）. However, in the low calcium group, systolic pressure, diastolic pressure and mean arterial pressure decreased significantly after dialysis （P〈0.05）. Relatively great difference was observed in serum calcium concentration and blood pressure between the two groups after dialysis（P〈0.01）. Conclusion High calcium concentration of dialysate during hemodialysis results in a high serum calcium concentration and subsequently a high blood pressure. Dialysate with lower calcium concentration is helpful for the control of blood pressure in uremia patients.

关 键 词：慢性肾衰 血液透析 透析液 钙 血压 

分 类 号：R459.5[医药卫生—治疗学]