药用炭对维持性血液透析病人肾功能、钙磷失衡的影响  

Effects of medicinal charcoal tablets on renal function and imbalance of calcium and phosphorus in patients with maintenance hemodialysis

作　　者：张青[1] 李志云 ZHANG Qing;LI Zhiyun(Pharmacy Department,Tai’an City Fourth People’s Hospital,Taian,Shandong 271000,China;Internal Medicine Department,Tai’an City Fourth People’s Hospital,Taian,Shandong 271000,China)

机构地区：[1]泰安市第四人民医院药剂科,山东泰安271000 [2]泰安市第四人民医院内科,山东泰安271000

出　　处：《安徽医药》2020年第9期1859-1862,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨药用炭对维持性血液透析病人肾功能、钙磷失衡的影响。方法 2017年1月至2018年1月在泰安市第四人民医院进行维持性血液透析的100例病人,按随机数字表法分为研究组和对照组,每组50例。对照组口服盐酸司维拉姆。研究组在口服盐酸司维拉姆治疗的基础上,口服药用炭(爱西特片)。治疗时间均为5个月。分别于基线、治疗后1个月、3个月、5个月时空腹采集静脉血。采用化学法测定血中钙、磷、尿素氮、血肌酐、血浆白蛋白(Alb)、β2微球蛋白(β2-MG)、Ⅰ型前胶原氨基端延长肽(PINP)、β-胶原降解产物(β-CTX)、骨钙素水平,计算钙磷乘积。采用放射免疫法检测血清全段甲状旁腺激素(i PTH)水平。统计两组治疗期间不良反应发生情况。结果研究组治疗后的钙、磷、钙磷乘积[治疗后5个月:(4.35±0.42)mmol^2/L^2比(4.74±0.38)mmol^2/L^2]、iPTH、尿素氮[治疗后5个月:(17.50±1.78)mmol/L比(19.54±1.78)mmol/L]、血肌酐[治疗后5个月:(715.60±67.41)μmol/L比(802.50±77.48)μmol/L]、β2-MG、PINP、β-CTX、骨钙素改善情况均明显优于对照组。两组不良反应发生率差异无统计学意义(χ^2=0.364,P=0.547)。结论在西医治疗的基础上加用药用炭对维持性血液透析病人钙磷失衡、甲状旁腺功能亢进与肾功能衰竭治疗具有一定的可行性。Objective To investigate the effect of medicinal charcoal tablets on renal function and calcium and phosphorus imbal⁃ance in patients with maintenance hemodialysis.Methods From January 2017 to January 2018,100 patients undergoing mainte⁃nance hemodialysis in at the Fourth People’s Hospital of Tai’an were randomly divided into study group and control group accord⁃ing to the random number table method,with 50 patients in each group.The control group received oral sevelamer hydrochloride.On the basis of oral sevelamer hydrochloride treatment,the study group took Aixit medicinal carbon tablets orally.The treatment duration is 5 months.Venous blood was collected on an empty stomach at baseline,1 month,3 months and 5 months after treatment,re⁃spectively.Chemical methods were used to determine blood calcium,phosphorus,urea nitrogen,blood creatinine,plasma albumin(Alb),β2 microglobulin(β2⁃MG),type I procollagen amino terminal extension peptide(PINP),β⁃collagen degradation products(B⁃CTX),the level of osteocalcin,Chemical methods were used to the levels of blood calcium(Ca),phosphorus(P),urea nitrogen(BUN),serum creatinine(Scr),plasma albumin(Alb),β2 microglobulin(β2⁃MG),type I procollagen amino terminal elongation peptide(PINP),β⁃collagen degradation product(β⁃CTX),osteocalcin and the product of calcium and phosphorus was calculated.Radioimmunoassay was used to detect the level of serum parathyroid hormone(iPTH).The adverse reactions of the two groups dur⁃ing the treatment were statistically analyzed.Results The level of Calcium,phosphorus,calcium and phosphorus product of the study group 5 months after treatment:(4.35±0.42)mmol2/L2 vs.(4.74±0.38)mmol2/L2,iPTH,urea nitrogen 5 months after treat⁃ment:(17.50±1.78)mmol/L vs.(19.54±1.78)mmol/L,blood creatinine 5 months after treatment:(715.60±67.41)μmol/L vs.(802.50±77.48)μmol/L,The improvement ofβ2⁃MG PINP,β⁃CTX and osteocalcin were significantly better than the control group.There was no significant difference in the inciden

关 键 词：肾功能衰竭 慢性/治疗 血液透析滤过 炭 司维拉姆 维持性血液透析 高磷血症 肾性骨病 

分 类 号：R692.5[医药卫生—泌尿科学]