CAPD与CCPD对钙、磷和PTH转运的对比研究  

Comparative Study on the Peritoneal Transport of Calcium,Phosphorus and PTH with CAPD and CCPD

作　　者：廖瑾岚[1] 罗琼[1] 侯霜[1] 熊子波[1] 张帆[1] 高敏[1] 廖玉梅[1] 

机构地区：[1]北京大学深圳医院肾内科,深圳518036

出　　处：《中国中西医结合肾病杂志》2013年第6期507-509,共3页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：深圳市科技局基金资助项目(No.201102021)

摘　　要：目的:探讨持续非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)与持续循环腹膜透析(con-tinuous cyclic peritoneal dialysis,CCPD)对钙、磷、甲状旁腺激素(parathyroid hormone,PTH)及血肌酐、尿素氮转运的影响。方法:选择2010年1月～2012年12月在北京大学深圳医院腹透中心常规CAPD治疗透析不充分并伴继发性甲状旁腺功能亢进的腹透患者20例,行腹膜平衡试验(peritoneal equilibration test,PET)了解腹膜转运特性,并计算基础Kt/V,然后给予CCPD治疗10d,检测CCPD治疗前后血及腹透液肌酐、尿素氮、Ca2+、P3-、Ca×P、iPTH,记录患者每日超滤量和尿量;比较CAPD与CCPD两种透析模式对上述指标影响。结果:CCPD治疗10d后总Kt/V由基线的1.73±0.33升高至2.30±0.37(P<0.05),Ccr/w由(47.43±7.61)L·wk-1·1.73m-2升高(61.69±10.52)L·wk-1·1.73m-2(P<0.05);血磷由(2.39±0.52)mmol/L降至(2.03±0.43)mmol/L(P<0.01);钙磷乘积由(66.73±15.84)mg2/dl2降至(58.81±13.64)mg2/dl2(P<0.05);iPTH由(84.85±15.84)pmol/L降至(58.81±13.64)pmol/L,差异均有统计学意义(P<0.05)。结论:短期CCPD能增加腹膜对小分子毒素(Cr、BUN)的清除,提高Kt/V和CCr值,并能降低血磷、iPTH水平。Objective：To investigate the differences of peritoneal transport for calcium, phosphorus, PTH,serum creatinine and urea nitrogen between continuous ambulatory peritoneal dialysis （CAPD） and continuous cycling peritoneal dialysis （CCPD）. Methods：Twenty inadequate peritoneal dialysis patients accompanied with secondary hyperparathyroidism, who were treated with CAPD from January 2010 to December 2012 at the Dialysis Center of Peking University Shenzhen Hospital were selected for this study. Before giving CCPD treatment, peritoneal equilibration tests （PET） had been done and the baseline Kt /V were calculated, after 10-day CCPD treatment, we measured the blood and dialysate creatinine, urea nitrogen, Ca, P, Ca × P, iPTH levels and recorded daily ultrafiltration volumes with urine outputs. Results：After giving a 10-day CCPD treatment, total Kt / V increased from a baseline of 1.73 ± 0.33 to 2.30 ± 0.37（P〈0.05）, Ccr / w increased from （47.43±7.61）L·wk-1·1.73 m-2 to （61.69 ± 10.52）L·wk-1·1.73 m-2（P〈0.05）; serum phosphorus from （2.39±0.52）mmol /L to （2.03±0.43）mmol/L（P〈0.01）; calcium-phosphorus product from （66.73±15.84）mg2/dl2 to （58.81±13.64）mg2/dl2（P〈0.05）; iPTH by （84.85±15.84）pmol/L dropped to （58.81±13.64）pmol /L（P〈0.05）, these differences have statistical significance. Conclusion：A short-term of CCPD therapy can enhance both peritoneal removal of small molecule toxins （Cr,BUN） and improve Kt/V and Ccr/w, reduce serum phosphate and iPTH levels.

关 键 词：持续非卧床腹膜透析 持续循环腹膜透析 钙 磷 甲状旁腺激素 Kt V 

分 类 号：R692.5[医药卫生—泌尿科学]