口服活性炭片降低血液透析患者血磷的疗效观察

Oral activated charcoal suppresses hyperphosphatemia in hemodialysis patients

目的观察口服活性炭片对血液透析患者高磷血症的疗效。方法给予50例血液透析患者口服活性炭片,观察治疗前、治疗一个月及三个月时血磷、血钙、血红蛋白、血清铁、铁蛋白、血白蛋白、血清全段甲状腺旁素(iPTH)水平。结果 1.与治疗前相比,治疗一个月及三个月时血磷水平明显下降(2.87±0.61vs2.19±0.49vs1.56±0.28),差异有统计学意义(P<0.05);2.治疗后钙磷乘积也有显著下降,(64.1±11.6vs56.7±9.8vs51.6±8.3),差异有统计学意义(P<0.05);3.治疗3个月时92%的患者血磷水平达标;4.19例应用含钙磷结合剂仍然存在高磷血症的患者,口服活性炭3个月后血磷均降至正常水平;5.口服活性炭片对血钙、血红蛋白、血清铁、铁蛋白、血白蛋白、iPTH水平无影响。结论口服活性炭片可有效降低维持性血液透析患者血磷和钙磷乘积,其降磷效果优于含钙磷结合剂。

【Objective】To observe the effect of oral activated charcoal on hyperphosphatemia in maintenance hemodialysis patients.【Methods】50 maintenance hemodialysis patients were given activated charcoal for oral use,the level of serum phosphorous,calcium,haematoglobin,serum iron,serum ferritin,serum albumin,intact parathyroid hormone（iPTH） were measured before therapy and 1 month and 3 month during the therapy.【Results】1.There were statistically significant decrease in serum phosphorous between pretherapy,one-month and three-month treatment（2.87 ± 0.61 vs 2.19 ± 0.49 vs 1.56 ± 0.28 P〈 0.05）.2.Calcium and phosphate product decreased significantly too（64.1 ± 11.6 vs 56.7 ± 9.8 vs 51.6 ± 8.3 P〈 0.05）.3.92% patients have normal serum phosphorous at the end of three-month treatment.4.There were 19 patients who had hyperphosphatemia when treated with calcium carbonate,all of them had ideal serum phosphorus levels at the end of the oral activated charcoal treatment.5.Oral activated charcoal has no effect on serum calcium,haematoglobin,serum iron,serum ferritin,serum albumin and iPTH during the treatment.【Conclusion】Oral activated charcoal is an effective therapy for the control of hyperphosphatemia in maintence hemodialysis patients.The ability of phosphorus control with oral activated charcoal per meal appears to be more powerful than that of calcium-based phosphate binders.