低钙透析液对维持性血液透析患者颈动脉钙化的影响  

Influence of low calcium dialysate on carotid artery calcification in maintenance hemodialysis patients

作　　者：刘艳石[1] 吴燕平 李月红 

机构地区：[1]天津中医药大学,天津300193 [2]天津市中西结合医院,天津300100

出　　处：《吉林医学》2011年第4期654-656,共3页Jilin Medical Journal

摘　　要：目的:观察低钙透析液对维持性血液透析患者颈动脉钙化的影响。方法:选择30例有颈动脉粥样硬化并使用标准钙透析液(钙1.75 mmol/L)进行维持性血液透析的患者,改用低钙透析液(钙1.25 mmol/L)进行治疗。观察周期为12个月,每3个月采用多普勒超声检测颈动脉内膜中层厚度(IMT)、颈动脉血流阻力指数(R I)、颈动脉粥样斑块数量和超声分型的变化;每6个月检测血清钙、磷、镁、血清甲状旁腺素(iPTH)。结果:患者改用低钙透析液后,颈动脉IMT逐渐变薄,伴随着颈动脉R I降低。血钙、血磷及钙磷乘积明显下降(P<0.05),血iPTH明显增加(P<0.01),血镁无明显改变(P>0.05)。结论:与高钙透析液相比低钙透析可有效降低维持性血液透析患者血钙水平,防止并减轻患者颈动脉钙化程度。Objective To observe the effect of low calcium dialysate on carotid artery calcification in maintenance hemodialysis pa- tients. Method Thirty patients with carotid atherosclerosls and in maintenance hemodialysis with standard calcium dialysate （calcium 1.75 mmol/L） ,were selected and changed to treat with low calcium （calcium 1.25 mmol/L） therapy. Every three months, carotid intimamedia thickness （IMT）,the carotid artery flow resistance index （RI）, the carotid ultrasound atheromatous plaques number and type of change was collected through Doppler ultrasound device. Every six months, the serum calcium, phosphate, magnesium, serum parathyroid hormone （iPTH） were measured. These data were continuously monitored for 12 months. Results Replacing with low calcium dialysate ,the patients＇ carotid IMT became thinner accompanied with the lowering of carotid RI. Serum calcium, phosphate and hyperphosphoremia de- creased obviously（P 〈 0. 05 ）, blood iPTH increased significantly（ P 〈 0. 01 ）,and without significant changes in blood magnesium（ P 〉 0. 05）. Conclusion Low calcium dialysis can effectively reduce the maintenance hemodialysis patients＇ serum calcium level, prevent and relieve carotid artery calcification contrasted with high calcium dialysate.

关 键 词：血液透析 低钙透析液 颈动脉钙化 血钙 甲状旁腺素 

分 类 号：R692.5[医药卫生—泌尿科学]