腹膜透析患者干预血压、钙磷代谢及甲状旁腺功能亢进对左心室重量影响的临床观察

Clinical observation of effect of blood pressure,calcium-phosphorus and hyperparathyroidism intervention on left ventricular weight in patients with peritoneal dialysis

目的探讨腹膜透析患者临床干预血压、钙磷代谢及甲状旁腺功能亢进对左心室重量的影响。方法 (1)选取宁夏医科大学附属医院终末期肾病腹膜透析治疗6个月以上的患者37例,分别测定腹膜透析治疗前后血压、血钙、血磷、甲状旁腺激素、身高、体重以及左室重量及左室重量指数,进行统计学分析。(2)以治疗后血钙﹥8.8mg/dL、血磷<4.6mg/dL、iPTH70～300pg/d为治疗有效,进行统计学分析。结果 37例患者平均动脉压、血钙、血磷、钙磷乘积、甲状旁腺激素、左室重量及左室重量指数治疗前后差异均有统计学意义。结论积极控制血压、钙磷代谢紊乱、甲状旁腺激素亢进等,可降低终末期腹膜透析患者心血管疾病的发生率及死亡率。

Objective To investigate the effect of blood pressure,calcium-phosphorus and hyperparathyroidism intervention on left ventricular weight in patients with peritoneal dialysis.Methods （1）Thrity-seven cases of patients with end-stage renal disease treated with peritoneal dialysis for at least six months in affiliated hospital of Ningxia medical university were selected.Indicators of blood pressure,serum calcium,serum phosphate concentration,parathyroid hormone,height,weight,left ventricular weight and left ventricular weight index were detected before and after peritoneal dialysis treatment,then the results were analyzed statistically.（2）The treatment effective standard was serum calcium concentration 8.8 mg/dL,serum phosphate concentration4.6 mg/dL,iPTH 70-300 pg/d after treatment,then the statistical analysis was conducted.Results There were significant differences in mean arterial pressure,serum calcium concentration,serum phosphate concentration,calcium-phosphorus product,parathyroid hormone,left ventricular weight and left ventricular weight index between before and after treatment.Conclusion Positively controlling blood pressure,calcium phosphate metabolic disorder and parathyroid hormone hyperthyroidism can reduce incidence and mortality of cardiovascular disease in end-stage peritoneal dialysis patients.