维持性血液透析患者高磷血症治疗的研究进展  

Research progress in the treatment of hyperphosphatemia in maintenance hemodialysis patients

作　　者：朱慧敏[1] 师军华 王东红[1] ZHU Hui-min;SHI Jun-hua;WANG Dong-hong(Department of Nephrology,The Fifth Central Hospital of Tianjin,Tianjin 300451,China)

机构地区：[1]天津市第五中心医院肾内科,天津300451

出　　处：《中国城乡企业卫生》2020年第8期55-58,共4页Chinese Journal of Urban and Rural Enterprise Hygiene

摘　　要：高磷血症是维持性血液透析(MHD)患者常见的并发症,它是导致MHD患者心血管疾病病死率升高的常见原因之一。传统的降磷治疗包括饮食治疗、磷结合剂和血液透析。近年来许多研究发现一些高磷血症对MHD患者的新的影响(包括透析过程中高血清磷减少率,血磷达标状况与MHD患者的动脉硬化的关系等)、高磷血症发生相关因素的新发现(例如透析前碳酸氢盐浓度、适当控制高能量饮食等)、新的饮食教育模式(如运动、依从性的改善)、新型药物治疗如铁基磷酸盐结合剂、不同血液净化方式如高效on-line血液透析滤过联合血液透析等,可以有效改善MHD患者的预后,提高患者生存质量。本文将围绕高磷血症对MHD患者的影响、高磷血症发生的相关因素、饮食教育、药物治疗、血液净化方式的研究进展进行综述,以期为高磷血症的临床治疗提供参考依据。Hyperphosphatemia is a common complication in maintenance hemodialysis(MHD)patients,which is one of the common causes of increased mortality of cardiovascular disease in MHD patients.Traditional phosphorus reduction therapy include diet therapy,the phosphate binders and hemodialysis.In recent years,many studies have found some new effects of hyperphosphatemia on MHD patients(including higher intra-dialysis serum phosphorus reduction ratio during dialysis,the relationship between serum phosphorus compliance status and atherosclerosis in MHD patients,etc),new discoveries of hyperphosphatemia happened related factors(such as concentration of bicarbonate before dialysis,appropriate control of high-energy food,etc),and a new diet education mode(such as sports,improved adherence),new drugs such as ferrous phosphate binder,different blood purification methods such as high efficiency on-line hemodiafiltrat combined with hemodialysis,etc.All of these can effectively improve the prognosis of MHD patients and improve the quality of life of patients.This article will focus on the research progress of the influence of hyperphosphatemia on MHD patients,the related factors of hyperphosphatemia,diet education,drug treatment and blood purification methods,in order to provide reference basis for the clinical treatment of hyperphosphatemia.

关 键 词：维持性血液透析 高磷血症 治疗 

分 类 号：R320.2435[医药卫生—人体解剖和组织胚胎学]