慢性血透病人76例血铝水平分析  

Levels of Serum Aluminum and the Correlative Factors in 76 Chronic Hemodi alysis Patients

作　　者：俞香宝[1,2] 胡建明[1,2] 赵卫红[1,2] 王笑云[1,2] 王沭沂[1,2] 

机构地区：[1]南京医科大学第一附属医院肾内科,江苏南京210029 [2]南京医科大学应用毒理实验室,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2001年第5期429-431,共3页Journal of Nanjing Medical University(Natural Sciences)

摘　　要：目的 :测定血透病人血铝浓度 ,探讨与甲状旁腺激素 ( PTH)、钙离子 ( Ca2 + )、及服用活性维生素 D3 ( AVD)的关系。方法 :石墨炉原子吸收分光光度法检测血、反渗水铝水平 ,放免法检测血 PTH,生化法检测血钙 ,分析它们之间的关系 ;统计服用及未服用 AVD的病人数 ,分析其与血铝的联系。 2 1例健康献血者的血铝水平作对照组。结果 :血透病人血铝水平 ( 13 1.0± 10 7.0 )μg/ L ,健康对照组为 ( 10 .3 0± 9.5 7)μg/ L ,两者差异有显著性 ( P<0 .0 0 1) ;高铝血症 (血铝 >10 0μg/ L )发生率为 3 6.8%( 2 3 5 .2 5± 114 .78μg/ L) ,PTH增高者占 78.6%( 4 3 3 .81± 2 62 .97pg/ ml) ,血铝与 PTH的 r=0 .18( P>0 .0 5 ) ;血 Ca2 +水平为 ( 2 .13±0 .3 6) m mol/ L ,与血铝的 r=0 .2 7( P>0 .0 5 ) ;服用 AVD组 4 1例病人中高铝血症 12例 ( 2 9.2 7%) ,未服用 AVD组 3 5例中高铝血症 16例 ( 4 5 .71%) ,两者间差异无显著性 ( P>0 .0 5 ) ;糖尿病组 i PTH( 5 3 .12± 4 6.99pg/ ml)低于铝正常的非糖尿病组 ( 3 91.8±181.5 6pg/ ml,P<0 .0 5 )。结论 :血透病人血铝负荷高 ,其血铝水平与 PTH、钙、AVD使用无相关性 ,血透治疗的糖尿病病人 PTH值低。Objective:To measure serum aluminum concentra tion, an d to explore the relationship with serum iPTH and serum calcium and active vitam in D(AVD) in chronic hemodialysis patients. Methods:76 patients on c hr onic hemodialysis, including 58 males and 18 females, aged from 18 to 74 years ( 16 cases above 65 years). Serum aluminum levels was measured by nonflame atomize r atomic absorption spectrophotometry and iPTH lavels by radioimmunoassay calciu m levels by biochemical assay. AVD was administed in 41 patients (0.25 μg 0.5 μg daily).Results:Serum aluminum levels was significantly elevated compared hemodialysis patients to controls[(131±107)μg/L, (10.30±9.57) μg/L ,respectively, P <0.001]. Serum aluminum levels in 28 of 76 patients were elevated (101 458 μg/L), including 20 males, 8 females, and 6 cases above 65 y ears. No relationship with sex, age and hemodialysis time was found. The proport ion of iPTH was 78.6%[(433.81±262.97) pg/ml], swerum calcium levels was (2 1 3±0 36)mmol/L. Statistical analysis showed no correlation between serum alumin um and iPTH( r= 0 097, P> 0 05), and serum aluminum were not relative t o serum calcium ( r =0.27, P >0.05). The proportion of elevated serum alum inum was not significantly difference between AVD group and no AVD group (29.27% , 45.71% resepctively, P >0.05)?Compared diabetes (DM) group to no diabetes group with normal serum aluminum levels, serum iPTH levels was significantly lo wer [(53.12±46.99) pg/ml, (391.8±181.56) pg/ml, respectively, P<0.05 ]. Conclusion:Serum aluminum load was higher in hemodialysis patients a nd the proportion of elevated serum aluminum was 36 8%. Serum aluminum was not si gnificantly associated with iPTH and serum calcium and AVD. Serum iPTH levels ma y be lower in diabetes hemodialysis patients.

关 键 词：血液透析 血铝 甲状旁腺激素 维生素D3 铝 

分 类 号：R459.5[医药卫生—治疗学] Q581[医药卫生—临床医学]