醋酸钙降低慢性肾脏病5期患者血磷水平及钙磷乘积的临床疗效观察  

The clinical efficacy of calcium acetate on hyperphosphatemia and calcium-phosphorus product in CKD5 patients

作　　者：张艳[1] 安娜[2] 梁新华[1] 

机构地区：[1]新疆医科大学第五附属医院肾病科,乌鲁木齐830011 [2]新疆医科大学第五附属医院内分泌科,乌鲁木齐830011

出　　处：《新疆医科大学学报》2014年第8期1028-1030,共3页Journal of Xinjiang Medical University

基　　金：新疆医科大学科研创新基金(XJC2011100)

摘　　要：目的：探讨口服醋酸钙对慢性肾脏病5期患者血磷与钙磷乘积的影响。方法采用单中心、前瞻性、自身前后对照研究的方法，选择经饮食控制后仍存在高磷血症的慢性肾脏病5期且已进入透析及尚未进入透析的51例患者，餐中加服醋酸钙1．334～4 g/d 治疗2个月。观察治疗前、治疗1个月及2个月时血磷、血钙、钙磷乘积及血清全段甲状腺旁素水平（iPTH）的变化。结果治疗2个月后患者血磷水平为（2．29±0．34）mmol/L，较治疗前的（1．94±0．30）mmol/L 显著下降，差异有统计学意义（P ＜0．01）；治疗后血钙磷乘积为（51．77±8．35）mg2/dL2，较治疗前的（61．51±8．81）mg2/dL2也明显下降（P ＜0．01）；治疗前后血钙与 iPTH 水平无明显变化。结论口服醋酸钙可有效降低血磷水平与钙磷乘积，对血钙及 iPTH 水平无明显影响。Objective To study the effect of calcium acetate on serum phosphoms level and calcium-phos-phorus products in CKD5 patients with poorly-controlled hyperphosphatemia.Methods A single-centered, prospective,and self-controlled study was conducted.51 CKD5 patients,with hyperphosphatemi remained by dietcontrol,with or without dialysis,were given calcium acetate 1.334-4.002 g per day with meals for two months.The levels of blood phosphorus,calcium,calcium-phosphorus products and intact parathyroid hormone （iPTH）were detected before and after the treatment.The results were analyzed by paired t-test. Results After 2 months of treatment,the patients′serum phosphorus level was significantly reduced from （2.29±0.34）mmol/L （pretreatment）to （1.94±0.30）mmol/L （posttreatment）（P 〈0.01）;the serum calcium-phosphorus products were declined from pre-treatment level of （61.51±8.81）mg2/dL2 （P 〈0.01） to posttreatment of （51.77 ± 8.35）mg2/dL2 ;there were no significant changes in serum calcium and iPTH levels when compared preto posttreatment values （P = 0.731,0.654 respectively）.Conclusion Oral calcium acetate can effectively reduce serum phosphorus levels and calciumphosphorus product,but with no significant effect on serum calcium and iPTH levels.

关 键 词：醋酸钙 慢性肾脏病 高磷血症 

分 类 号：R692.5[医药卫生—泌尿科学]