醋酸钙联合碳酸镧对尿毒症患者钙磷代谢及心脏瓣膜钙化的临床研究  

Clinical Study of Calcium Acetate Combined with Lanthanum Carbonate on Calcium and Phosphorus Metabolism and Cardiac Valve Calcification in Patients with Uremia

作　　者：陈晴 陈仁芬 谢丽红 CHEN Qing;CHEN Renfen;XIE Lihong(Department of Nephrology,Longyan People's Hospital,Longyan,Fujian Province,364000 China)

机构地区：[1]福建省龙岩人民医院肾内科,福建龙岩364000

出　　处：《中外医疗》2023年第29期104-107,共4页China & Foreign Medical Treatment

摘　　要：目的探讨醋酸钙联合碳酸镧对尿毒症患者钙磷代谢及心脏瓣膜钙化的临床效果。方法方便选择2020年5月—2023年5月在福建省龙岩人民医院诊治的尿毒症患者140例,根据治疗方法分为两组,各70例。所有患者都给予血液透析治疗,对照组在透析期间给予醋酸钙治疗,观察组在对照组治疗的基础上给予碳酸镧治疗,两组都治疗观察3个月,记录钙磷代谢及心脏瓣膜钙化变化情况。结果治疗后两组尿素清除指数值高于治疗前,肌酐清除率值低于治疗前,且观察组优于对照组,差异有统计学意义(P<0.05)。治疗后两组血磷水平低于治疗前,观察组低于对照组,差异有统计学意义(P<0.05);两组治疗前后血钙水平对比,差异无统计学意义(P>0.05)。治疗后两组血清肿瘤坏死因子、白细胞介素-6含量低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组治疗期间的心脏瓣膜钙化发生率为2.86%,低于对照组的15.71%,差异有统计学意义(χ^(2)=59.566,P<0.05)。结论在尿毒症患者透析中应用醋酸钙联合碳酸镧治疗能调节钙磷代谢,减少心脏瓣膜钙化的发生,抑制炎症因子的表达,从而促进改善患者的肾功能。Objective To investigate the clinical effect of calcium acetate combined with lanthanum carbonate on cal⁃cium and phosphorus metabolism and cardiac valve calcification in patients with uremia.Methods A total of 140 ure⁃mia patients diagnosed and treated in Longyan People's Hospital of Fujian Province from May 2020 to May 2023 were conveniently selected and divided into two groups according to treatment methods,with 70 cases in each group.All pa⁃tients were treated with hemodialysis,the control group was treated with calcium acetate during dialysis,and the obser⁃vation group was treated with lanthanum carbonate on the basis of the control group.Both groups were treated and ob⁃served for 3 months,and the changes of calcium and phosphorus metabolism and heart valve calcification were re⁃corded.Results After treatment,the urea clearance index value of the two groups was higher than before treatment,and the creatinine clearance value was lower than before treatment,and the observation group was better than the con⁃trol group,and the difference was statistically significant(P<0.05).After treatment,the blood phosphorus level of the two groups was lower than before treatment,and the observation group was lower than the control group,and the differ⁃ence was statistically significant(P<0.05).There was no statistically significant difference in blood calcium level be⁃tween the two groups before and after treatment(P>0.05).After treatment,the serum tumor necrosis factor and inter⁃leukin-6 contents in 2 groups were lower than before treatment,and the observation group was lower than the control group,and the difference was statistically significant(P<0.05).The incidence of cardiac valve calcification in the observation group was 2.86%,which was lower than that in the control group(15.71%),and the difference was statisti⁃cally significant(χ^(2)=59.566,P<0.05).Conclusion The application of calcium acetate combined with lanthanum car⁃bonate in dialysis of uremia patients can regulate calcium and phosphor

关 键 词：血液透析 醋酸钙 碳酸镧 尿毒症 钙磷代谢 心脏瓣膜钙化 

分 类 号：R692.5[医药卫生—泌尿科学]