静滴钙剂减少血液透析后QTc离散度增大的观察

The calcic agent infusion in reducing the QTc dispersion enlargement after hemodialysis

从观察血液透析患者血透中滴注钙剂提高血钙水平能否减少QTc离散度 (QTcd)的增大 ,推知能否减少室颤发生。对 32例血透患者作正常血透前后和同时以 10 %葡萄糖酸钙 30ml +5 %GS15 0ml滴注的血透前后体重、血压、心率 ;脱水量 ;血钙、磷、钾、肌酐测定及QTcd测量。结果显示 :两次透析时体重、血压、心率、脱水量、透后血磷、钾、肌酐差异无显著性。静滴钙剂血透后血钙较正常透后显著升高 ;正常血透后QTcd上升显著 ,静滴钙剂血透后QTcd较透前上升不显著 ,较正常血透后显著减小。提示透析时滴注钙剂后室颤发生几率下降 。

The improvement of the levels of serum calcium by calcic agent infusin in patients during hemodialysis could reduce the enlargement of QTcd, this could predict the occurrence of ventricular fibrillation. The weight, blood pressure, heart rate; dehydration amount, serum calcium, phosphorus, potassium, creatinine and QTcd were measured in 32 patients before and after normal hemodialysis (divided as group A), meanwhile, the mentioned above data before and after hemodialysis were measured in patients who were also infused with 30ml of 10%calglucon plus 150ml of 5%GS during hemodialysis (divided as groupB). Results showed that in these two groups, there were no significant differences between weight, blood pressure, heart rate, dehydration amount, post-hemodialysis blood phosphorus, potassium and creatinine. But in groupB, the blood serum increased more significantly than that in groupA. The QTcd increased significantly after hemodialysis in groupA. In groupB, the QTcd increased less significantly than that before hemodialysis and reduced significantly than that in the groupA. This study indicated that the calcic agent infusion during hemodialysis could reduce the incidence of the probability of ventricular fibrillation so that it could lessen the risk of the sudden death of the patients with hemodialysis.