不同钙浓度透析液对维持性血液透析患者血管钙化的影响

EFFECTS OF CALCIUM CONCENTRATION IN DIALYSATE ON VASCULAR CALCIFICATION OF MAINTENANCE HEMODIALYSIS PATIENTS

目的探讨不同钙浓度透析液对维持性血液透析(maintenance hemodialysis,MHD)患者血管钙化的影响。方法 100例MHD患者分析使用高钙(DCCa1.75)和低钙(DCa1.25)透析液进行透析治疗,X线检查血管钙化情况。结果 MHD患者血管钙化总发生率66%,DCa1.75组和DCa1.25组血管钙化发生率为分别为66.7%和65.0%(P>0.05);血管钙化与透析后血钙、磷及其乘积显著相关,OR值分别为14.3、13.2和18.7;控制血钙、磷后发现,钙磷乘积的OR值上升为38.6。结论 MHD应根据患者血钙、血磷水平来选择透析液中钙浓度,同时也可以通过口服钙剂来调节血钙血磷水平以维持血钙血磷在正常水平为标准。保持MHD血钙血磷稳定在正常水平,是防止血管钙化的重要途径。

Objective To investigate the effects of calcium concentration in dialysate on vascular calcification of maintenance hemodialysis （MHD） patients. Methods One hundred MHD patients were grouped and treated with high calcium dialysate （ DCal. 75 ） and low calcium dialysate （ DCal. 25 ）, respectively. X ray detected vascular calcification. Results Total vascular calcification rate of 100 MHD patients was 66%. The rates of DCal. 75 group and DCal. 25 group were 66.7% and 65.00% （ P 〉 0.05 ） , respectively. There were significant relation between vascular calcification and serum calcium, serum phosphorus and calcium -phosphorus product after hemodialysis, the values of OR were 14.3,13.2 and 18.7 ;The OR value of calcium -phosphorus product was up to 38.6 in the case of controlling serum calcium and phosphorus. Conclusion The choosing of calcium concentration in dialysate should be based on serum calcium and phosphorus of MHD patients;And the regulations of serum calcium and phosphorus into normal levels could be achieved by oral taking calcium. Maintaining normal levels of serum calcium and phosphorus of MHD patients play an important role in preventing the vascular calcification.