腹膜透析患者钙磷代谢状况的临床分析  

Clinical Analysis of Calcium and Phosphate Metabolism in Peritoneal Dialysis Patients

作　　者：张帆[1] 罗琼[1] 廖玉梅[1] 侯霜[1] 王青[1] 熊子波[1] 熊祖应[1] 

机构地区：[1]北京大学深圳医院肾内科,广东深圳518036

出　　处：《罕少疾病杂志》2012年第3期1-4,共4页Journal of Rare and Uncommon Diseases

摘　　要：目的调查我院腹膜透析患者血钙、磷及甲状旁腺激素(PTH)达标情况,观察低钙透析液的治疗效果。方法横断面调查2011年12月在北京大学深圳医院规律随访腹膜透析时间大于6个月的腹膜透析患者血钙、磷及全段甲状旁腺激素(iPTH)水平。将最近6个月及6个月以上一直用普通钙腹透液(钙离子浓度为1.75mmol/L)的患者定义为普钙组,用低钙腹透液(钙离子浓度为1.25mmol/L)的患者定义为低钙组,比较两组患者各指标差异。比较低钙组患者改用低钙透析液前后钙、磷、iPTH指标变化。结果 178名腹膜透析患者血钙达标率73.6%;血磷达标率49.4%;iPTH达标率仅26.4%,53.4%患者iPTH低于目标值。低钙组患者血磷、iPTH高于普钙组(P<0.05)。用低钙透析液后患者血钙降低,血磷、iPTH升高(P<0.05)。结论腹膜透析患者血钙、磷和iPTH达标率低,半数以上患者iPTH低于目标值。对高血钙、iPTH低的患者建议使用低钙透析液,但必须同时加强降磷治疗。Objectivve To investigate blood calcium, phosphate and PTH in peritoneal dialysis patients. To observe the treatment effect of low calcium dialysate. Methods We investigated blood calcium, phosphate and intact parathyroid hormone （iPTH） in 178 peritoneal dialysis patients who were regularly followed up at least 6 months. Patients with regular calcium dialysate （calcium concentration was 1.75mmol/L） were defined as regular calcium group. Patients with low calcium dialysate （calcium concentration was 1.25mmol/L） were defined as low calcium group. Chemical examinations wered compared between the two teams. And blood calcium, phosphate and iPTH were compared that before and after low calcium dialysates were used. Results 73.6% patients blood calcium was within the recommended values. 49.4% patients blood phosphate was within the recommended values. 26.4% patients iPTH was within the recommended values. Blood phosphate and iPTH of low calcium group were higher than regular calcium group （P〈0.05）. After low calcium dialysates were used at least 6 months, blood calcium decreased, phosphate and iPTH increased （P〈0.05）. Conclusions Blood calcium, phosphate and iPTH were not well controlled in majority peritoneal dialysis patients. We recommend to use low calcium dialysate in high blood calcium and （or） low iPTH patients, and we should enhance treating high blood phostphate.

关 键 词：腹膜透析 低钙透析液 钙磷代谢 甲状旁腺激素 

分 类 号：R45[医药卫生—治疗学]