不同血液净化方式联合骨化三醇冲击治疗对维持性血液透析患者肾性骨病的治疗效果  

Effect of different kinds of blood purification with implosive therapy of caldtriol for renal osteopathy in patients with maintenance hemodialysis

作　　者：孙培荣[1] 马列清[1] 刘静[1] 张军[1] 李德新[1] 王凡[1] 

机构地区：[1]首都医科大学附属北京佑安医院泌尿中心,100069

出　　处：《国际移植与血液净化杂志》2015年第1期13-15,共3页International Journal of Transplantation and Hemopurification

摘　　要：目的观察不同血液净化方式联合骨化三醇冲击治疗对维持性血液透析患者肾性骨病的疗效，探讨治疗肾性骨病的最佳方案。方法将45例符合标准的患者按数字表法随机分为3组，每组15例。普通透析组接受血液透析治疗；血液透析滤过组接受血液透析滤过治疗，每2周1次；血液透析灌流组接受血液透析联合血液灌流治疗，每2周1次。所有患者均使用骨化三醇冲击治疗。检测治疗0、1、3个月血清钙、磷、甲状旁腺素水平。结果治疗前3组患者血清钙、磷、甲状旁腺素水平差异无统计学意义（尸〉0．05）。治疗1个月及3个月后，血液透析组患者血钙、血磷下降水平，三组间两两比较差异无统计学意义（P〉0．05）。血液透析组甲状旁腺素水平治疗1个月及3个月与治疗前比较差异无统计学意义（P〉0．05）；治疗3个月与治疗前及治疗1个月比较差异有统计学意义（P〈0．05）。血液透析滤过组和血液透析灌流组甲状旁腺素水平治疗1个月、3个月与治疗前比较明显下降，差异有统计学意义（P〈0．05），治疗3个月与治疗1个月比较，差异有统计学意义（P〈0．05）。血液透析灌流组甲状旁腺素水平治疗3个月和治疗1个月比较，差异无统计学意义（P〉0．05）。治疗3个月时，甲状旁腺素水平血液透析滤过组与血液透析灌流组比较差异有统计学意义（P〈0．05）。结论对维持性血液透析肾性骨病的患者而言，血液透析滤过及血液透析灌流联合骨化三醇冲击治疗可以有效控制肾性骨病。Objective To observe the effect of different kinds of blood purification with implosive therapy of calcitriol for renal osteopathy in patients with maintenance hemodialysis（MDH）. Methods Forty- five patients of MDH with renal osteopathy who received implosive therapy of calcitriol were randomly individed into three groups,with 15 patients in each group. The A group received conventional hemodialysis （HD）. The B group received the treatment of hemodiafihration（HDF）, once per two weeks. The C group received the treatment of HD＋ hemoperfusion（HP）, once per two weeks. Ca^2＋ ,P and PTH were detected before treatment and after 1 and 3 months＇ treatment. Results No significant difference in Ca^2＋ , P, PHI in three groups before treatment. One and 3 months later, no significant difference of PTH was found when compared with baseline in A group. However, there were significant difference in B and C groups in comparison with baseline. There were significant difference, which of PTH, between 1 and 3 months later in B and C groups. Three months later, there were significant difference, which of PTH, between B, C and A group. Conclusion Renal osteopathy in patients with MDH could be treated by HDF with using implosive therapy of calcitriol.

关 键 词：血液透析 血液透析滤过 血液透析灌流 骨化三醇 肾性骨病 维持性血液透析 

分 类 号：R459.5[医药卫生—治疗学]