低钙腹透液对持续性腹膜透析患者高钙血症的影响  

Low calcium dialysate effect on hypercalciumia in patients with continuous ambulatory peritoneal dialysis

作　　者：于克洲[1] 孙晶[1] 王熙宁[1] 宋双[1] 

机构地区：[1]山东省立医院,山东济南250021

出　　处：《山东医药》2007年第22期17-18,共2页Shandong Medical Journal

摘　　要：目的观察低钙腹透液(PD4,钙离子浓度为1.25mmol/L)对高钙血症持续性腹膜透析(CAPD)患者钙磷代谢的影响。方法45例使用标准钙腹透液(PD2,钙离子浓度为1.75mmol/L)后出现高钙血症的CAPD改用PD4透析,监测患者治疗前后血钙、磷、全段甲状旁腺激素(PTH)的变化,同时分析影响血钙水平变化的相关因素。结果完成6个月观察的41例患者2个月后即出现血钙、磷水平明显降低,PTH较前明显升高(P<0.05)。血钙下降幅度与患者的年龄呈负相关,而与透析剂量和超滤量呈正相关(P<0.05)。结论PD4可有效调节CAPD患者的高钙血症,缓解低转运性骨病的发生和发展。[ Objective ] To study the effect of low-calcium dialysate （ PD4, 1.25 mmol/L calcium dialysate） on calcium-phosphate metabolism of continuous ambulatory peritoneal dialysis （CAPD） patients with hypercalcaemia and analysis the correlation with other parameters. [ Method ] 45 CAPD patients who had hypercalcaemia with PD2 （ 1.75 mmol/L calcium dialysate） had been changed to PD4. The level of serum calcium and phosphate were evaluated at every month as well as parathyroid hormorue （PTH） and serum albumin. [ Result] 41 patients completed the examination. After 6 months there was no difference in the level of albumin, volume of dialysis, ultrafiltration and total outcome（ P 〉 0. 05 ）. After 2 months the level of calcium began to be decreased significantly as well as phosphate（ P 〈 0. 05 ）. Otherwise the level of PTH increased significantly compared with baseline （ P 〈 0. 05 ）. The decrease in percentage index of calcium showed negative correlation with age and positive correlation with volume of dialysis and ultrafiltration（ P 〈 0. 05 ）. [ Conclusion ] PD4 may optimize the level of calcium in the CAPD patients with hypercalciumia, and control of serum calcium-phosphate metabolism, prevent the progression of adynamic bone diseases.

关 键 词：透析 腹膜 高钙血症 血钙 血磷 甲状旁腺激素 

分 类 号：R692.5[医药卫生—泌尿科学]