血液透析联合血液灌流在维持性血液透析患者钙磷代谢紊乱治疗中的应用  

Application of Hemodialysis Combined with Hemoperfusion in Treating Phosphorus and Calcium Metabolism Disorders in Maintenance Hemodialysis Patient

作　　者：胡绮雯[1] 龙海波[1] 温足珍[1] 许敏玲[1] 蔡琪[1] 许月嫦[1] 

机构地区：[1]南方医科大学附属小榄医院肾内科,广东中山528415

出　　处：《河北医学》2015年第1期35-39,共5页Hebei Medicine

基　　金：广东省中山市医学科研基金项目;(编号:2013A020219)

摘　　要：目的:探讨血液透析联合血液灌流在维持性血液透析患者钙磷代谢紊乱治疗中的应用效果。方法:选择本院2013年6月至2013年12月接受维持性透析治疗的尿毒症患者80例,按照随机数字法分为两组,各40例。治疗组为血液灌流联合血液透析组,对两组患者治疗前、后临床指标的变化,以及患者临床症状改善情况。结果:治疗后治疗组的血磷、钙磷乘积、i PTH、BUN、Scr和β2-MG均显著下降,血钙含量显著升高,且治疗后4个月及6个月在血磷、血钙、钙磷乘积、i PTH和β2-MG含量方面与对照组存在统计学差异(P<0.05)。治疗6个月后治疗组P1NP、β-CTX和BGP含量均显著下降,且均与对照组存在统计学差异(P<0.05)。结论:血液透析与血液灌流联合使用具有可有效降低MHD患者体内血清全段甲状旁腺素含量,纠正钙磷代谢紊乱。Objective：To investigate the influence of hemodialysis （ HD） and hemoperfusion （ HP ） on calcium-phosphate metabolism disorders in maintenance hemodialysis patients .Method：Eighty maintenance hemodialysis patients in our hospital from June 2013 to December 2013 were randomly divided into two groups.Forty patients in treatment group received HD and HP , the changes of biochemical indicators before and after treatment in jtwo groups were compared .Result：Serum phosphorus , calcium and phosphorus prod-ucts, intact parathyroid（iPTH）, blood urea nitrogen（BUN）, serum creatinine（Scr） and β2-microglobulin in treatment group were decreased after treatment , while the serum calcium were increased significantly , the level of serum phosphorus and calcium , calcium and phosphorus products , iPTH and β2-MG were different with those of control group（P〈0.05）.The level of procollagen type I N-terminal propeptide（P1NP）, beta-isomerized C-telopeptide （β-CTX） and bone glaprotein were all decreased , and had significantly different with control group（P〈0.05）.Conclusion：HD combined with HP can decrease the level of iPTH in mainte-nance hemodialysis patients , and also can regulate the calcium-phosphate metabolism disorders .

关 键 词：血液透析 血液灌流 钙磷代谢紊乱 

分 类 号：R692.5[医药卫生—泌尿科学]