低分子肝素钠对血液透析患者钙磷代谢影响的临床观察

Effect of Low Molecular Weight Heparin Sodium on Calcium Phosphorus Metabolism in Patients Undergoing Hemodialysis: Clinical Observation

目的:探讨低分子肝素钠对维持性血液透析患者钙磷代谢的影响。方法:选取2012年5月至2013年5月收治的166例血液透析患者作为研究对象,按随机表法将其分成对照组和试验组,对照组予以普通肝素钠,试验组予以低分子肝素钠,对两组患者的血钙、血磷、甲状旁腺激素(PTH)、碱性磷酸酶(ALP)水平、出血发生率、体外循环凝血发生率进行观察比较。结果:治疗前两组患者血钙、血磷、PTH、ALP水平差异无统计学意义(P>0.05)。对照组治疗前后血磷、PTH水平无明显变化(P>0.05)。透析后,试验组血磷及PTH水平显著降低,与对照组比较,差异有统计学意义(均P<0.05)。两组治疗前后血钙和ALP水平差异均无统计学意义(均P>0.05)。试验组的出血发生率明显低于对照组(P<0.01)。两组体外循环凝血发生率差异无统计学意义(P>0.05)。结论:低分子肝素钠可能有改善钙磷代谢异常的作用。

OBJECTIVE：To explore the effect of low molecular weight heparin sodium on calcium- phosphorus metabolism in patients undergoing hemodialysis. METHODS： From May 2012 to May 2013, a total of 166 patients undergoing hemodialysis were randomly divided into either control group receiving unfractionated heparin or experimental group receiving low molecular weight heparin sodium. The two groups were followed and compared with regard to serum levels of calcium, phosphorus, parathyroid hormone （PTH） and alkaline phosphatase （ALP）, the incidences of bleeding and blood clotting during cardiopulmonary bypass. RESULTS ： Before treatment, serum levels of calcium, phosphorus, PTH and ALP showed no significant difference between the two groups （P 〉 0. 05 ）. Serum phosphorus and PTH levels did not change significantly in the control group before and after treatment （ P 〉 0. 05 ）. After hemodialysis, serum phosphorus and PTH levels were significantly reduced in the experimental group, and the differences were statistically significant between the experimental group and the control group （ P 〈 0. 05 ）. The differences in calcium and ALP levels in the two groups before and after treatment were not statistically significant （P 〉 0. 05 ）. The incidence of bleeding in the experimental group was significantly lower than in the control group （P 〈0.01 ）. The incidence of blood clotting during cardiopulmonary bypass showed no significant difference between two groups （ P 〉 0.05 ）. CONCLUSION ： The low molecular heparin sodium might be effective for improving calcium- phosphorus metabolism.