不同钙浓度透析液对维持性血液透析合并高血压患者血压及钙磷乘积的影响

Effects of different calcium concentrations dialysate on blood pressure and multiplication of calci- um and phosphorus in maintenance hemodialysis patients with hypertension

目的探讨不同钙浓度透析液对维持性血液透析合并高血压患者血压及钙磷乘积的影响。方法以佛山市南海区第七人民医院2009年1月至2011年6月期间，因慢性肾功能衰竭维持性血液透析合并高血压的患者28例作为研究对象。观察前患者应用1．75mmolfL钙浓度透析液3个月以上，进入观察后改用1．25mmol／L钙浓度透析液连续透析3个月。观察前后检测患者血钙、血磷及钙磷乘积，记录单次透析前后收缩压和舒张压。结果调整透析液钙浓度3个月后，患者单次透析后收缩压、舒张压明显下降，差异有统计学意义（P〈0．05）；患者钙磷乘积亦明显降低（P〈0．05）。结论1．25mmol／L钙浓度透析液可改善维持性血液透析患者高血压在透析过程中血压的控制，并改善钙磷代谢。

Objective To investigate the effects of different calcium concentration dialysate on blood pressure and multiplication of calcium and phosphorus in maintenance hemodialysis patients with hy- pertension. Methods Twenty-eight maintenance hemodialysis patients with hypertension as research ob- jects who were treated in the seventh people＇ s hospital of Nanhai district from January 2009 to June 2011 were choosed. Before the observation, all patients were dialysed with dialysate calcimu of 1.75 mmol/L for more than 3 months. During the observation, the dialysate calcimu concentration was changed into 1.25 mmol/L and last for 3 months. The blood calcium, blood phosphorus and multiplication of calcium and phosphorus of the patients were measmed before and after dialysis at the begin and the third month. Meanwhile, the systolic blood pressure（SBP） and diastolic blood pressure（DBP） before and after a single dialysis process were recorded. Results Post-dialysis SBP and DBP of the patients decrease significantly after adjusting over 3 months （P 〈 O. 05 ）. The multiplication of calcium and phosphorus also decreased dramatically （P 〈 0. 05 ）. Conclusions Dialysate with calcium concentration of 1.25 mmol/L could help the blood pressure control during the dialysis for maintenance hemodialysis patients with hypertension and could also improve the metabolism of calcium and phosphate.