不同钙浓度透析液对维持性血液透析患者血甲状旁腺素及钙磷代谢的影响

Influence of Calcium Concentration in Dialysate on Calcium,Phosphate and Parathyroid Hormone for Hemodialysis Maintaining Patient

目的研究不同钙浓度透析液对血液透析患者钙磷代谢及甲状旁腺素(iPTH)的影响。方法 30例维持性血液透析患者随机分为3组,分别采用钙浓度1.25、1.5mmol/L及1.75mmol/L透析液连续进行3个月血液透析治疗,此期患者饮食中钙磷的摄入量稳定,用药不变。实验前检测透析前血iPTH,透析前后血钙和血磷浓度。3个月后复查透析前血iPTH,透析前后血钙和血磷浓度。结果观察结束时DCa1.25、DCa1.5和DCa1.75组,血清Ca×P水平:DCa1.25组血清Ca×P水平明显降低(P<0.01)、DCa1.5组无变化、DCa1.75组升高(P<0.05);iPTH水平:DCa1.25组显著升高(P<0.01),DCa1.5组升高(P<0.05),DCa1.75组降低(P<0.05)。结论高钙透析可增加透析患者的钙负荷及转移性钙化的发生,低钙透析可在有限时间内减轻高钙负荷,但长期应用低钙透析液应监测iPTH水平。

Objective To study the affection of varied calcium concentration in dialysis fluid for calcium and phosphate metabolism, and parathyroid of hemodialysis patient.Methods 30 cases of such patientwere divided into 3 groups.The varied calcium concentration fluid of 1.25,1.5 and 1.75mmol/Lwas given in hemodialysis for 3 months.During this peried,the patientsmaintained stable for diet and medication.The Ca,P,iPTH were detected before furthertherapy and were compared. Results The CaXP level was decreased in DCa 1.25 group, no change in 1.5 group and increased in 1.75 group.The iPTH level was increased in DCa 1.25 group, l.5 group and decreased in 1.75 group.Conclusion The high concentration of calcium in dialysis fluid might increase the calcium load and transverse calcium happening.The low calcium concentration might decrease calcium load,but monitoring of iPTH level should be taken.