血液透析滤过对终末期肾病患者钙磷代谢及心血管并发症的影响  

Effects of hemodiafiltration on calcium-phosphorus metabolism and cardiovascular complication in patients with end-stage renal disease

作　　者：张帆[1] 江杨 龚宇 罗逊[1] ZHANG Fan;JIANG Yang;GONG Yu(Department of Nephrology,Hunan Provincial People’s Hospital(First Affiliated Hospital of Hunan Normal University),Changsha 410002,China;Department of Nephrology,Hanshou County People’s Hospita,Changde 415918,China)

机构地区：[1]湖南省人民医院(湖南师范大学附属第一医院)肾内科,湖南长沙410002 [2]汉寿县人民医院肾内科,湖南常德415918

出　　处：《中国实验诊断学》2023年第1期17-20,共4页Chinese Journal of Laboratory Diagnosis

基　　金：2019年湖南省卫健委B类科研课题(B2019069)。

摘　　要：目的 探讨血液透析滤过对终末期肾病患者钙磷代谢及心血管并发症发生的影响。方法 选取2021年1月至2022年1月我院收治的60例终末期肾病血液透析患者,将每周两次血液透析患者设为HD组,每周两次血液透析联合每两周一次血液透析滤过患者设为HDF组。比较两组患者治疗前后钙磷代谢指标变化及心血管并发症发生情况。结果 治疗后,两组患者血钙(Ca)、血磷(P)、甲状旁腺激素(iPTH)水平均较治疗前改善,差异有统计学意义(P<0.05);治疗后HDF组患者血钙(Ca)水平为(2.34±0.16)mmoL/L,高于HD组的(2.16±0.17)mmoL/L,差异有统计学意义(P<0.05);治疗后,HDF组心律失常的发生率较HD组降低,差异有统计学意义(P<0.05),两组患者心血管并发症总发生率差异无统计学意义(P>0.05)。结论 对于终末期肾病患者,血液透析滤过能有效改善钙磷代谢紊乱,对于心血管并发症的发生有一定的改善作用。Objective To explore the effects of hemodiafiltration calcium-phosphorus metabolism and cardiovascular complication in patients with end-stage renal disease.Methods The data of 60 hemodialysis patients with end-stage renal disease admitted to our hospital from January 2021 to January 2022 were analyzed retrospectively.It was divided into the HD group and HDF group.The patients in the HD group received hemodialysis treatment twice a week, and the patients in the HDF group received hemodialysis twice a week combined with biweekly hemodiafiltration.The changes of calcium and phosphorus metabolism indexes and cardiovascular complications of the two groups were compared before and after treatment.Results After treatment, the levels of blood calcium(Ca),blood phosphorus(P)and blood parathyroid hormone(iPTH) improved both in HD and HDF group, the differences were statistically significant(P<0.05);After treatment, the levels of calcium(Ca) in HDF group was(2.34±0.16)mmoL/L,which was higher than(2.16±0.17) mmoL/L in HD group, the differences was statistically significant(P<0.05);After treatment, the incidence of arrhythmia in HDF group decreased compared with HD group, the differences were statistically significant(P<0.05).There was no significant difference in the incidence of cardiovascular complications between the two groups(P>0.05).Conclusion For patients with end-stage renal disease, hemodiafiltration could effectively improve the calcium and phosphorus metabolism disorders and to some extent reduce the incidence of cardiovascular complication.

关 键 词：血液透析 血液透析滤过 终末期肾病 钙磷代谢 心血管并发症 

分 类 号：R692[医药卫生—泌尿科学]