单次不同血液净化方式对慢性肾脏病-矿物质和骨异常患者钙磷及甲状旁腺素的影响  

Effect of single different blood purification on serum calcium,phosphate and parathyroid hormone in chronic kidney disease-mineral and bone disorder patients

作　　者：李铭[1] 张金平[1] 陈芳[1] 刘春[1] 

机构地区：[1]石河子大学医学院第一附属医院肾病科

出　　处：《临床肾脏病杂志》2015年第12期739-743,共5页Journal Of Clinical Nephrology

基　　金：石河子大学第一附属医院院级课题(NO.YL2015-R007)

摘　　要：目的观察单次不同血液净化方式对慢性肾脏病-矿物质和骨异常患者血钙（Ca）、血磷（P）、甲状旁腺素（parathyroid hormone，PTH）的影响，为临床治疗提供依据。方法选择石河子大学医学院第一附属医院维持性血液透析并继发性甲状旁腺功能亢进（secondary hyperparathyroidism，SHPT）患者60例，随机分为低通量血液透析（hemodialysis，HD）组、血液透析滤过（hemodiafiltration，HDF）组、高通量血液透析（high-flux hemodialysis，HFHD）组，每组20例，采用血生化自动分析仪检测各组治疗前后血钙、血磷的水平，采用化学发光仪检测各组治疗前后PTH的水平，比较其治疗前、后的变化。结果单次HD、HDF、HFHD治疗后与治疗前相比，血钙水平均上升（P〈0．05），血磷水平均明显下降（P〈0.05），PTH水平无明显变化（P〉0.05），比较3组治疗前、后血钙、血磷变化程度无明显差异（P〉0．05）。结论单次HD、HDF、HFHD治疗均可达到降低血磷、升高血钙的效果，且效果无差异，但均不能有效清除PTH。因此，3种血液净化方式在纠正钙磷代谢紊乱方面效果相同，可依据各医院及患者具体情况开展。Objective To investigate the effect of single different blood purification therapy on related factors of renal osteodystrophyserum： calcium（Ca）, phosphorus（P） and parathyroid hormone （PTH） in maintenance hemodialysis patients, so as to provide evidence for clinic therapy. Methods A total of 60 cases of First Affiliated Hospital of Medical College of Shihezi University with hemodialysis and secondary hyperparathyroidism（SHPT）, divided into hemodialysis（HD） group, hemodiafiltration （HDF） group, high-flux hemodialysis（HFHD） group randomly, 20 cases in each group, each group＇ Ca, P levels were analyzed by biochemical analyzer, and each group＇ PTH levels were analyzed by chemiluminescence analyzer, then the changes of pre-treatment and post-treatment＇ Ca, P, PTH levels were compared. Results Compared the Single HD, HDF, HFHD pre-treatment with post-treatment, we have a conclusion that the Ca＇ level increase（P〈0. 05）, the serum P level decrease significantly（P 〈0. 05）, PTH＇ level was not significantly change（P〉0. 05）. Comparing the changes of Ca, P levels, the three groups have no significant difference（P〉0. 05）. Conclusions HD, HDF and HFHD treatment both have the effect of decreasing the P and increasing the Ca, and have no difference in effect, but can not effectively decrease the PTH, so the three blood purifications have the same effect on correcting the Ca and P disorder, we can develop the blood purification based on each hospital and patient ＇ specific circumstances.

关 键 词：甲状旁腺素 血钙 血磷 

分 类 号：R692.5[医药卫生—泌尿科学]