不同血液净化方式对慢性肾脏病矿物质和骨异常的临床研究  

Clinical research of different blood purification ways on chronic kidney disease mineral and bone disorder

作　　者：雷凡[1] 陈荩国 冯新国[2] 

机构地区：[1]长沙医学院附属株洲市三三一医院肾内科,湖南长沙412002 [2]长沙医学院附属株洲市三三一医院检验科,湖南长沙412002

出　　处：《现代医药卫生》2014年第20期3056-3057,3060,共3页Journal of Modern Medicine & Health

摘　　要：目的观察2种不同血液净化方式对维持性血液透析患者高血钙、高血磷、高血清甲状旁腺激素、皮肤瘙痒的改善效果。方法选择该院2012年4月至2013年4月进行维持性血液透析且病情稳定患者18例,随机分为单一组和联合组,各9例;单一组采用血液透析滤过(HDF)治疗,联合组采用血液透析(HD)联合血液灌流(HP)治疗。分别在治疗前及治疗后2周检查患者血钙、血磷、钙磷乘积和全段甲状旁腺激素(iPTH)。结果治疗2周后两组患者血钙均有所上升,血磷、iPTH均有所下降,与治疗前比较,差异均有统计学意义(P<0.05);此外,联合组患者血磷及iPTH清除率均明显大于单一组,差异均有统计学意义(P<0.05)。结论 HDF和HD联合HP均能有效清除血磷和iPTH,但HD联合HP更有效。Objective To observe the effect of two different blood purification ways[hemodiafiltration（HDF）,hemodialysis with hemoperfusion（HD with HP）] on hypocalcemia,hyperphosphatemia,high serum parathyroid hormone and pruritus improvement of patients with maintance hemodialysis. Methods A total of 18 patients with maintance hemodialysis and stable disease from April 2012 to April 2013 were selected and randomized into single group and combination group ,9 cases in each group. The sin-gle group used HDF for treatment,while the combination group adopted HD with HP for treatment. Before treatment and 2 weeks after treatment,the blood calcium,blood phosphorus,calcium-phosphorus product and intact parathyroid hormone（iPTH） were checked respectively. Results After 2 weeks of treatment,toth groups had an increase of blood calcium,while blood phosphorus and iPTH were decreased,and compared with the condition before treatment,the differences were statistically significant（P〈0.05）. In addition,blood phosphorus and iPTH clearance rate of combination group was obviously greater than those of the single group with statistically significant difference（P〈0.05）. Conclusion HDF and HP combined with HD can effectively remove blood phosphorus and iPTH,but the HP with HD has better effect.

关 键 词：血液灌注 血液透析滤过 高磷血症/治疗 甲状旁腺素 

分 类 号：R587.2[医药卫生—内分泌]