低钙透析联合骨化三醇胶囊治疗对血液透析患者钙磷水平及血压的影响

Influence of the application of low-calcium dialysate in combination with capsule calcitriol on phosphorus levels and blood pressure for maintenance hemodialysis patients

目的研究低钙透析联合骨化三醇胶囊治疗对血液透析患者钙磷水平及血压的影响。方法选取2016年1月—2017年1月在我院治疗的维持性血液透析患者56例,按照随机数表的方法将其分成DCa1.25与DCa1.5组各28例,根据患者的甲状旁腺激素(PTH)水平给予不同剂量的骨化三醇胶囊,观察比较两组患者治疗前以及治疗1个月、3个月、6个月后血清钙、磷、钙磷乘积、PTH、骨碱性磷酸酶(BAP)水平以及血压的变化。结果两组患者的血清钙、磷以及钙磷乘积在处理效应与时间效应之间存在着交互作用(P<0.05),治疗后的DCa1.5组患者在血清钙、磷以及钙磷乘积上呈上升趋势,而DCa1.25组患者均呈下降趋势,且于治疗3个月后趋于稳定。两组患者血PTH、BAP水平无交互作用,不具有统计学意义(P>0.05)。两组患者的SBP处理效应与时间存在交互作用(P<0.05),DCa1.5组患者治疗前后的SBP、DBP水平无明显差异(P>0.05),DCa1.25组患者治疗后的DBP以及SBP水平与治疗前相比明显降低(P<0.05)。结论 DCa1.25透析液联合骨化三醇胶囊对于降低钙磷水平效果较好,值得在临床推广应用。

Objective： To research the influence of the application of low-calcium dialysate in combination with capsule calcitriol on phosphorus levels and blood pressure for maintenance hemodialysis patients. Methods： Fifty-six hemodialysis patients from January 2016 to January 2017 were selected and divided into two groups with 28 cases according to table of random numbers. Then patients were given different doses of calcitriol capsules according to parathyroid hormone levels,and the level of calcium and phosphorus in serum,and calcium-phosphorus product,PTH and bone alkaline phosphatase level and blood pressure were compared after treatment at 1,3,6 months. Results： There was the effect of interaction between two groups in serum calcium,phosphorus and calcium-phosphorus level（ P〈0. 05）. There was upward trend of DCa1. 5 group after treatment on serum calcium,phosphorus and calcium-phosphorus product,and DCa1. 25 group showed a downward trend,which after 3 months of treatment stabilized. The PTH and BAP levels of two groups had no interaction（ P〈0. 05）. There was interaction between the two groups at SBP level（ P〈0. 05）,and there was no significant difference at SBP,DBP levels before and after treatment in DCa1. 5 patients（ P〈0. 05）. Compared with the previous level,DBP and SBP in DCa1. 25 patients after treatment was significantly lower（ P〈0. 05）. Conclusion： DCa1. 25 dialysate joint calcitriol capsules for reducing calcium and phosphorus levels have good results,which is worthy of clinical application.