低钙透析液对维持性血液透析患者钙磷代谢及甲状旁腺激素的影响  

Influence of low calcium dialysate calcium on calcium and phosphorus metabolism and parathyroid hormone in patients with maintenance hemodialysis

作　　者：苗畅贤[1] 谢宪敏[1] 丛志华[1] 

机构地区：[1]辽宁省大连市第三人民医院肾内科,辽宁大连116033

出　　处：《实用临床医药杂志》2017年第3期29-31,共3页Journal of Clinical Medicine in Practice

摘　　要：目的探讨低钙透析液对非低钙血症维持性血液透析患者的钙磷代谢以及甲状旁腺激素的影响。方法将60例非低钙血症维持性血液透析患者随机分为观察组与对照组,观察组采用低钙透析液(Ca^(2+)浓度为1.25 mmol/L),对照组采用常规透析液(Ca^(2+)浓度为1.50 mmol/L),比较2组患者的疗效。结果治疗后,观察组患者血清T-Ca、T-Ca×P显著下降,血清i PTH显著升高(P<0.05);对照组患者血清T-Ca、T-Ca×P显著升高,血清i PTH显著下降(P<0.05)。观察组患者血清T-Ca、T-Ca×P均显著低于对照组,血清i PTH均显著高于对照组(P<0.05)。治疗6个月后,观察组患者血清hs-CRP显著低于对照组(P<0.05)。2组患者不良反应发生率无显著差异(P>0.05)。结论非低钙血症维持性血液透析患者应用低钙透析液可以降低血清高钙负荷,改善甲状旁腺过度抑制状态与心血管炎症状态。Objective To explore the effect of low calcium dialysate on calcium and phosphorus metabolism and parathyroid hormone in patients with maintenance hemodialysis. Methods A total of 60 non-hypocalcemia patients with maintenance hemodialysis were randomly divided into observation group and control group. The observation group was treated with low calcium dialysate （ Ca2 ＋ concentration was 1.25 mmol/L） , while the control group was treated with conventional calcium dialysate （ Ca2 ＋ concentration was 1.50 mmoL/L）. Effect was compared between two groups. Results After treatment, the serum T-Ca, T-Ca x P significantly decreased in the observation group, and serum iPTH significantly increased （P 〈 0.05 ）. In the control group, the serum T-Ca, T-Ca x P significantly increased, and serum iPTH decreased significantly （P 〈 0.05 ）. The serum levels of T- Ca, T-Ca x P in the observation group were significantly lower than those in the control group, and the serum iPTH level was significantly higher than that in the control group （ P 〈 0.05 ）. After 6 months of treatment, the serum hs-CRP level of the observation group was significantly lower than that of the control group （P 〈 0.05 ）. There was no significant difference in the incidence rate of adverse reactions between the two groups （P 〉 0. 05 ）. Conclusion Application of low calcium dialysate can decrease serum high calcium loading, improve the status of excessive inhibition of parathyroid hormone and cardiovascular inflammation status in treatment of non-hypocalcemia patients with maintenance hemodialysis.

关 键 词：低钙透析液 维持性血液透析 钙磷代谢 甲状旁腺激素 

分 类 号：R459.5[医药卫生—治疗学]