低钙透析液联合高通量血液透析对尿毒症患者钙磷及血管钙化的影响  

Effect of high flux hemodialysis combined with low calcium dialysate on calcium phosphate and vascular calcification in patients with uremia

作　　者：伏广浩[1] 刘晓东[1] 

机构地区：[1]连云港市第二人民医院肾内科,江苏222023

出　　处：《现代医药卫生》2015年第9期1292-1294,共3页Journal of Modern Medicine & Health

摘　　要：目的观察低钙透析液联合高通量血液透析对改善尿毒症患者钙磷指标及血管钙化的临床疗效。方法选择2011年3月至2014年3月在该院行维持性血液透析患者48例,分为低钙透析液联合高通量血液透析(低钙联合HFHD组)、高通量血液透析组(HFHD组)和普通血液透析组(HD组),其中低钙联合HFHD组患者采用1.25 mmol/L钙离子浓度的低钙透析液,比较各组治疗前及治疗12个月后透前血钙、血磷、钙磷乘积及X射线腹主动脉钙化评分等指标。结果低钙联合HFHD组治疗12个月后血磷、钙磷乘积水平及血管钙化评分较治疗前下降,骨化三醇服用量减少,差异均有统计学意义(P<0.05),低钙联合HFHD组与HFHD组比较,差异均有统计学意义(P<0.05)。HD组患者治疗后各项指标与治疗前比较,差异均无统计学意义(P>0.05)。结论低钙透析液联合HFHD能有效改善高磷血症、降低钙磷乘积及血管钙化评分,减少骨化三醇用量,提高尿毒症患者生存质量。Objective To observe the clinical curative effect of low calcium dialysate combined with high flux hemodial-ysis on improving uremia patients with calcium phosphate indicators and vascular calcification. Methods A total of 48 patients with maintenance hemodialysis in this hospital from March 2011 to March 2014 were selected and divided into low calcium dialysate combined with high flux hemodialysis group（the low calcium＋HFHD group）,high flux hemodialysis group（HFHD group）, the ordinary dialysis（HD group）,in which,the low calcium＋HFHD group adopted 1.25 mmol/L calciumion concentration of car-bonate with low calcium dialysate. It was compared inserum phosphorus ,the calcium-phosphorus products and X-ray abdominal aortic calcification score between these groups before and after treatment 12 months. Results After 12-month treatment,the low calcium＋HFHD group was lower in serum phosphate ,calcium-phosphorus product and vascular calcification score than those be-fore the treatment,as well as less in dosage of calcitriol than that before for the treatment. The difference had statistical significance （P〈0.05）. There were statistical significance in difference between the low calcium＋HFHD group and HFHD group （P〈0.05）. All the indicators in HD group before the treatment had no statistical significance compared to those after the treatment （P〉0.05）. Conclusion It is effective to improve hyperphosphatemia and reduce the calcium-phosphorus product and vascular calcification scoreunder calcium dialysate combined with high flux hemodialysis to reduce the dosage of calcitriol ,improve the quality of ure-mia patients survival.

关 键 词：钙代谢障碍 磷/代谢 肾透析 尿毒症 营养状况 血管钙化 

分 类 号：R459.5[医药卫生—治疗学]