低钙透析联合高通量透析对透析患者颈动脉钙化的影响

The Effect of Low Calcium Dialysis Combination with High-flux Hemodialysis on Carotid Calcification in Hemodialysis Patients

目的:探讨低钙透析联合高通量透析(HFHD)对透析患者颈动脉钙化的影响。方法:将36例维持性血液透析(MHD)患者随机分为A组(使用高通量透析器)和B组(使用低通量透析器),两组均为低钙透析,共观察12个月。观察治疗前后两组颈动脉内-中膜厚度(IMT)、生化指标、血压、碳酸钙和活性维生素D3用量变化,记录不良反应。结果:(1)A组颈动脉IMT轻微增加,B组IMT明显增加,两组比较差异有统计学意义;(2)两组血钙、磷均有降低,A组较明显,B组甲状旁腺素(iPTH)明显升高,A组营养及炎症指标、血压改善优于B组;(3)两组碳酸钙及活性维生素D用量均增加;(4)无严重不良反应发生。结论:低钙透析联合高通量透析可改善血管钙化危险因素,延缓血管钙化的发生发展,可成为一种有效、安全且经济的治疗方法。

Objective：To explore the effect of low calcium dialysis combination with high-flux hemodialysis on carotid cal-cification in hemodialysis patients. Methods：36 patients on maintenance hemodialysis（ MHD） with low calcium dialysis for 12 months were randomly divided into group A（ high flux dialyzer）and group B（ low -flux dialyzers）. Carotid intimae -media thickness（ IMT）,biochemical parameters,blood pressure,the amount of calcium and active vitamin D3 were observed before and af-ter treatment. Results：（1）Group A increased slightly in carotid IMT while significantly increased by group B,there were statistical differences between two groups;（2）Serum of calcium,phosphorus were lower in two groups,especially in group A,while intact par-athyroid hormone（ iPTH）increased significantly in group B. Nutrition and inflammatory makers,blood pressure were improved better in group A than in group B.（3）The amounts of calcium and active vitamin D were increased in two groups;（4）No serious adverse events happened. Conclusion：Low calcium dialysis with HFHD can improve risk factors for vascular calcification,delay the develop-ment of vascular calcification,can be an effective,safe and economical method of treatment.