α-酮酸联合碳酸钙改善维持性血液透析患者钙磷代谢的疗效观察

Clinical observation of α-ketoacid combined with calcium carbonate in improvement of calcium and phosphorus metabolism in patients with maintenance hemodialysis

目的探究α-酮酸联合碳酸钙改善维持性血液透析患者钙磷代谢的临床疗效。方法选取2015年1月—2015年7月在崇州市人民医院进行维持性血液透析治疗的患者82例,随机分为对照组与治疗组,每组各41例。对照组患者口服碳酸钙D3片,600 mg/次,2次/d。治疗组在对照组基础上,餐中口服复方α-酮酸片,4片/次,3次/d。两组的治疗时间不低于6个月。分析两组患者治疗前、治疗后3、6个月血液中钙磷的量、钙磷乘积、血清中碱性磷酸酶(AKP)、甲状旁腺激素(PTH)水平、血白蛋白含量、综合性营养评估(SGA)及BMI指数的变化情况。结果治疗后3、6个月,两组患者的血磷量和钙磷乘积明显降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组的降低程度优于对照组(P<0.05)。治疗后3、6个月,两组PTH值均降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组的PTH值显著低于同期对照组,两组比较差异具有统计学意义(P<0.05)。治疗后3、6个月,两组血白蛋白量、SGA评分、BMI指数均得到改善,同组治疗前后差异具有统计学意义(P<0.05);且治疗组这些观察指标显著优于同期对照组,两组比较差异具有统计学意义(P<0.05)。结论复方α-酮酸联合碳酸钙能明显改善维持性血液透析患者的钙磷代谢情况,提高患者的营养状况,可有效的预防并发症发生。

Objective To observe the clinical effects of α-ketoacid combined with calcium carbonate in improvement of calcium and phosphorus metabolism in patients with maintenance hemodialysis. Methods Patients（82 cases） with maintenance hemodialysis in Chongzhou Hospital from January in 2015 to July in 2015 were randomly divided into control group and treatment group, and each group had 41 cases. The patients in the control group were po administered with Calcium Carbonate D3 Tablets, 600 mg/time, twice daily. The patients in the treatment group were po administered with Compound α-Ketoacid Tablets during the meals on the basis of the control group, 4 tablets/time, three times daily. The treatment time of two groups was not less than 6 months. Calcium and phosphorus, calcium-phosphorus product, AKP, PTH, serum albumin, SGA scores, and BMI in two groups before treatment and after treatment for 3 and 6 months were compared. Results After treatment for 3 and 6 months, blood phosphorus and calcium-phosphorus product in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And the decreased degree in the treatment group was better than that in the control group（P〈0.05）. After treatment for 3 and 6 months, PTH values in two groups were significantly decreased, and there were differences in the same group（P〈0.05）. And PTH values in the treatment group were significantly lower than those in the control group, with significant difference between two groups（P〈0.05）. After treatment for 3 and 6 months, serum albumin, SGA scores, and BMI in two groups were improved, and the difference was statistically significant in the same group（P〈0.05）. And these observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups（P〈0.05）. Conclusion Compound α-ketoacid combined with calcium carbonate can improve calcium and phosphorus metabolism in patients with maintenance hemodialysis and their nutritional status, which also can prevent complications effectively.