爱西特联合碳酸钙治疗血液透析患者高磷血症的疗效观察

Clinical efficacy of active charcoal combined calcium carbonate in the treatment of hyperphosphatemia in hemodialysis patients

目的观察爱西特联合碳酸钙治疗血液透析患者高磷血症的疗效。方法将72例存在高磷血症的维持性血液透析患者随机平分为三组,牡蛎碳酸钙组(A组)、爱西特组(B组)和牡蛎碳酸钙+爱西特组(C组),每组24例,治疗前、治疗1个月、3个月和6个月检测其血磷、血钙、白蛋白、血红蛋白和血清全段甲状旁腺激素(iPTH)的水平并进行比较分析。结果与治疗前比较,A组血清磷稍有下降,但差异无统计学意义,A组中有2例(8.3%)血清磷小于1.78 mmol/L;B组血清磷明显下降,治疗3个月降至最低(P<0.05),治疗6个月较治疗3个月无明显变化,B组中有4例(16.7%)血清磷小于1.78 mmol/L;C组血清磷下降最明显(P<0.05),治疗3个月降至最低,治疗6个月较治疗3个月无明显变化,C组中有8例(33.3%)血清磷小于1.78 mmol/L;与B组治疗3个月相比,C组的血磷明显下降(P<0.05);三组血钙、白蛋白、血红蛋白和iPTH的水平无明显变化。结论爱西特联合碳酸钙能有效治疗血液透析患者的高磷血症,疗效优于单用爱西特和碳酸钙。

Objective To observe the effect of active charcoal （aixite） combined calcium carbonate in the treatment of hyperphosphatemia in hemodialysis patients. Methods Seventy-two patients were randomly assigned in- to three groups： calcium carbonate group （group A）, active charcoal group （group B）, active charcoal and calcium car- bonate group （group C）. The level of serum phosphorous, calcium, haematoglobin, serum albumin, and intact parathy- roid hormone （iPTH） were measured before treatment and I month, 3 months and six months after treatment. Results In group A, the serum phosphorous levels were slightly decreased after treatment, showing no statistically significant difference with that before treatment （P〉0.05）. Two patients （8.3%） in group A had serum phosphorous levels lower than 1.78 mmol/L. In group B, the serum phosphorous levels were significantly decreased （P〈0.05）, reaching the low- est level 3 months after treatment, with no statistically significant difference between 3 and 6 months after treatment. Four patients （16.7%） in group B had serum phosphorous levels lower than 1.78 mmol/L. In group C, the serum phos- phorous levels were mostly significantly decreased （P〈0.05）, reaching the lowest level 3 months after treatment, with no no statistically significant difference between 3 and 6 months after treatment. Eight patients （33.3%） in group C had serum phosphorous levels lower than 1.78 mmol/L. There was statistically significant difference in serum phos- phorous levels between group B and group C 3 months after treatment （P〈0.05）. Calcium, haematoglobin, serum albu- min and iPTH showed no significant changes before and after treatment. Conclusion Active charcoal combined cal- cium carbonate is an effective therapy for the hyperphosphatemia in hemohemodialysis patients.