硫代硫酸钠在维持性血液透析患者冠状动脉钙化中的应用效果  

Effect of Sodium Thiosulfate on coronary artery calcification in maintenance hemodialysis patients

作　　者：朱兴华[1] 李颖玉[1] 陈璐[1] 丘宝珍 ZHU Xing-hua;LI Ying-yu;CHEN Lu;QIU Bao-zhen(Blood Purification Center,Meizhou People's Hospital,Guangdong Province,Meizhou 514031,China)

机构地区：[1]广东省梅州市人民医院血液净化中心,广东梅州514031

出　　处：《中国当代医药》2019年第13期105-108,共4页China Modern Medicine

摘　　要：目的探讨硫代硫酸钠在维持性血液透析患者冠状动脉钙化中的应用效果。方法选取2015年7月～2018年7月在我院血液净化中心治疗的46例维持性血液透析伴有冠状动脉钙化患者作为研究对象,按照不同治疗方法将其分为对照组和观察组,每组各23例。对照组患者采用常规治疗方法 ,观察组患者在此基础上使用硫代硫酸钠治疗。比较两组患者治疗前后的各项血生化指标[血磷、血钙、钙磷乘积、全段甲状旁腺激素(iPTH)、超敏C反应蛋白(hs-CRP)、尿素氮(BUN)、血肌酐(Scr)、尿酸(UA)、谷丙转氨酶(ALT)、清蛋白(Alb)、血红蛋白(Hb)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、碳酸氢根(HCO3-)、25-羟基维生素D(25(OH)D)、骨碱性磷酸酶(bALP)]、冠状动脉钙化积分(CACs)。结果两组患者治疗前的各项血生化指标比较,差异无统计学意义(P>0.05);两组治疗后的hs-CRP水平均明显低于治疗前,差异有统计学意义(P<0.05);观察组患者治疗后的HCO_3^-明显低于治疗前与对照组,差异有统计学意义(P<0.05);观察组患者治疗后的血磷、血钙、钙磷乘积、iPTH、hs-CRP、BUN、Scr、UA、ALT、Alb、Hb、TC、TG、HDL-C、LDL-C、25(OH)D、bALP与对照组比较,差异无统计学意义(P>0.05)。两组患者治疗前的CACs评分比较,差异无统计学意义(P>0.05);两组患者治疗后的CACs评分均明显低于治疗前,差异有统计学意义(P<0.05);观察组患者治疗后的CACs评分明显低于对照组,差异有统计学意义(P<0.05)。结论硫代硫酸钠对维持性血液透析患者冠状动脉钙化有一定延缓作用,能够抑制冠状动脉钙化进展,具有积极的临床意义。Objective To investigate the effect of Sodium Thiosulfate on coronary artery calcification in maintenance hemodialysis patients.Methods A total of 46 patients with maintenance hemodialysis and coronary artery calcification treated in the blood purification center of our hospital from July 2015 to July 2018 were selected as subjects.According to different treatment methods,they were divided into control group and observation group,23 cases in each group.Patients in the control group were treated with conventional treatment,and patients in the observation group were treated with Sodium Thiosulfate on the above basis.The blood biochemical parameters(blood phosphorus,blood calcium,calcium-phosphorus product,immunoreactive parathyroid hormone[iPTH],high sensitivity C-reactive protein[hs-CRP],blood urea nitrogen[BUN],serum creatinine[Scr],uric acid[UA],alanine aminotransferase[ALT],albumin[Alb],hemoglobin[Hb],total cholesterol[TC],triglyceride[TG],high-density lipoprotein cholesterol[HDL-C],low-density lipoprotein cholesterol[LDL-C],bicarbonate[HCO3-],25-hydroxyvitamin D[25(OH)D],bone alkaline phosphatase[bALP])and coronary calcification scores(CACs)were compared between the two groups before and after treatment.Results There were no significant differences in blood biochemical parameters between the two groups before treatment(P>0.05).The hs-CRP levels in the two groups after treatment were significantly lower than those before treatment,and the differences were statistically significant(P<0.05).The HCO3-after treatment in the observation group was significantly lower than that before treatment and in the control group,with statistically significant differences(P<0.05).There were no significant differences between the observation group and the control group after treatment in blood phosphorus,blood calcium,calcium-phosphorus product,iPTH,hs-CRP,BUN,Scr,UA,ALT,Alb,Hb,TC,TG,HDL-C,LDL-C,25(OH)D and bALP(P>0.05).There were no significant differences in CACs scores between the two groups before treatment(P>0.05).The CACs s

关 键 词：维持性血液透析 冠状动脉钙化 硫代硫酸钠 干预效果 

分 类 号：R459.5[医药卫生—治疗学]