低钙透析液对维持性血液透析患者难治性高血压的影响  

The influence of lower calcium dialysate on refractory hypertention in maintence hemodialysis patients

作　　者：郭民[1] 黄丽红[1] 李凯[1] 孙桂玲[1] 刘春霞[1] 谭君君[1] 

机构地区：[1]潍坊医学院附属医院,261031

出　　处：《中国医学创新》2010年第5期17-20,共4页Medical Innovation of China

基　　金：基金项目：2007年度山东省医药卫生科研项目（2007HZ022）

摘　　要：目的探讨低钙透析液对血液透析患者难治性高血压的影响。方法选取合并难治性高血压的维持性血液透析患者26例，采取自身对照的方法，先后应用钙浓度为1．75mmol／L（DCa2＋1．75）及1．25mmol／L（DCa2＋1．25）的透析液各连续进行20次透析，观察每次开始透析后0h、1h、2h、3h及透析结束时的血压，并分别与20次透析前后观察一般临床指标及血清总钙（Ca2＋）、磷（P3＋）、钙磷乘积及全段甲状旁腺激素（iPTH）的变化。结果与常规采用DCa2＋1．75比较，采用低钙透析液（DCa2＋1．25）进行透析，患者的血压降低，尤其在第3小时及透析结束后．差异有统计学意义（P〈0．05）；血钙、钙磷乘积降低（P〈0．05），其他临床指标差异无统计学意义（P〉0．05）。结论低钙透析液对维持性血液透析患者难治性高血压的控制有利。Objective To investigate the influence of low calcium dialysate on refractory hypertention in maintence hemodialysis（HD） patients. Methods Twenty six HD patients with refratory hypertension were enrolled in this study,patients were first used dialysate containing Ca2 ＋ 1.75 mmol/L for 20 times of HD and then that containing Ca2 ＋ 1.25mmol/L for 20 times of HD,blood pressure was measured at 0 h, 1 h,2 h,and 3 h during HI） and after the HD. Serum calcium,phosphate,intact parathroid hormone（iPTH） and other cinical parameter were determined before and after the use of low calcium dialysate. Results Blood pressure lowered in patients used Ca2＋ 1.25 mmol/L in dialysate,especially at 3 h during HD and after the HD. as compared with that in patients used Ca2 ＋ 1.75 mmol/L in dialysate（ P 〈 0.05 或 P 〈 0.01 ） ;Serum calcium and calcium -phosphate product were also decreased in those used Ca2＋ 1.25 mmol/L in dialysate（ P 〈 0. 05 ）. Conclusion Lower calcium dialysate may be favorable in control of hemodialysis - related refractory hypertension.

关 键 词：低钙透析液 血液透析 难治性高血压 

分 类 号：R459.5[医药卫生—治疗学] R544.1[医药卫生—临床医学]