维持性血液透析与持续不卧床腹膜透析对终末期肾病患者钙磷代谢及氧化应激的影响比较  

Comparison of the effect of maintenance hemodialysis and continuous ambulatory peritoneal dialysis on calcium and phosphorus metabolism and oxidative stress in patients with end-stage renal disease

作　　者：鲁冰[1] 任东升[1] 陶雅非[1] 王建刚[1] LU Bing;REN Dongsheng;TAO Yafei;WANG Jiangang(Department of Nephrology,Nanyang Central Hospital,Nanyang 473005,Henan Province,China)

机构地区：[1]南阳市中心医院肾内科,河南南阳473005

出　　处：《新乡医学院学报》2022年第9期833-837,共5页Journal of Xinxiang Medical University

摘　　要：目的探讨维持性血液透析与持续不卧床腹膜透析对终末期肾病患者钙磷代谢及氧化应激的影响。方法选择2019年1月至2021年10月南阳市中心医院肾内科收治的120例行透析治疗的终末期肾病患者为研究对象,按照随机数字表法将患者分为对照组和观察组,每组60例。对照组患者采用维持性血液透析治疗,观察组患者采用持续不卧床腹膜透析治疗,2组患者均连续治疗3个月。透析治疗前及连续透析治疗3个月后,使用全自动生物化学分析仪检测2组患者的血清钙、磷水平,采用硫代巴比妥酸法检测2组患者血清中丙二醛(MDA)水平,采用黄嘌呤氧化酶法检测2组患者血清中超氧化物歧化酶(SOD)水平,采用比色法检测2组患者血清中髓过氧化物酶(MPO)水平。比较2组患者连续透析治疗3个月后血清钙、磷达标率及透析治疗期间消化道出血、动静脉内瘘闭塞、感染、低蛋白血症及心功能异常等并发症发生情况。结果透析治疗前,2组患者血清钙、磷及MDA、SOD、MPO水平比较差异均无统计学意义(P>0.05)。透析治疗3个月后,2组患者的血清钙水平及对照组患者的血清磷水平与透析治疗前比较差异无统计学意义(P>0.05),观察组患者的血清磷水平显著低于透析治疗前(P<0.05)。透析治疗3个月后,2组患者的血清钙水平比较差异无统计学意义(P>0.05),观察组患者的血清磷水平显著低于对照组(P<0.05)。对照组患者血清钙达标35例(58.33%),血清磷达标16例(26.67%);观察组患者血清钙达标38例(63.33%),血清磷达标31例(51.67%);2组患者血清钙达标率比较差异无统计学意义(χ^(2)=0.315,P>0.05),观察组患者血清磷达标率显著高于对照组(χ^(2)=7.869,P<0.05)。透析治疗3个月后,2组患者血清中MDA、MPO水平显著高于透析治疗前(P<0.05),SOD水平显著低于透析治疗前(P<0.05)。透析治疗3个月后,观察组患者血清中MDA、MPO水平显著低于对照组(P<0Objective To investigate the effect of maintenance hemodialysis and continuous ambulatory peritoneal dialysis on calcium and phosphorus metabolism and oxidative stress in patients with end-stage renal disease.Methods A total of 120 patients with end-stage renal disease who received dialysis treatment in the Department of Nephrology of Nanyang Central Hospital from January 2019 to October 2021 were selected as the research objects,and the patients were divided into the control group and the observation group according to the random number table method,with 60 cases in each group.The patients in the control group were treated with maintenance hemodialysis,and patients in the observation group were treated with continuous ambulatory peritoneal dialysis,the patients in the both groups were treated for 3 months.Before dialysis treatment and after 3 months of continuous dialysis treatment,the serum calcium and phosphorus levels of the patients in the two groups were detected by the automatic biochemical analyzer,the serum malondialdehyde(MDA)level was detected by the thiobarbituric acid method,the serum superoxide dismutase(SOD)level was detected by the xanthine oxidase method,the serum myeloperoxidase(MPO)level was detected by the colorimetric method.The rate of serum calcium and phosphorus reaching the standard before dialysis treatment and after 3 months of continuous dialysis treatment between the two groups were compared,the complications such as hemorrhage of digestive tract,arteriovenous fistula occlusion,infection,hypoalbuminemia and abnormal cardiac function during dialysis treatment were compared between the two groups.Results There was no significant difference in serum calcium,phosphorus,MDA,SOD and MPO levels of patients between the two groups before dialysis treatment(P>0.05).After 3 months of dialysis treatment,there was no significant difference in the serum calcium level of patients between the two groups(P>0.05).There was no significant difference in serum phosphorus level of patients before dialysis

关 键 词：终末期肾病 血液透析 腹膜透析 钙磷代谢 氧化应激 

分 类 号：R692[医药卫生—泌尿科学]