醋酸钙联合高通量低钙透析治疗尿毒症患者高磷血症的临床效果

Clinical Effect of Calcium Acetate Combined with High-flux Low-calcium Dialysis in Treatment of Hyperphosphatemia in Uremia Patients

目的研究醋酸钙联合高通量低钙透析治疗尿毒症患者高磷血症对血钙及血磷水平的影响及临床效果。方法 2013年7月-2015年6月期间,将我院收治的126例尿毒症患者根据入院单双日均分为对照组和实验组,每组63例。两组患者均给予血液透析治疗,对照组口服碳酸钙片剂,每次1片,每天3次;实验组口服醋酸钙,每次2片,每天3次。比较两组患者治疗前后血钙、血磷、全段甲状旁腺激素水平的统计差异。结果两组患者治疗后30天和60天,血红蛋白、血浆白蛋白、钙磷乘积、矫正血钙、碱性磷酸酶含量的差异均有统计学意义(P<0.05);两组患者血磷、血钙、i PTH含量比较,差异有统计学意义(P<0.05);两组患者治疗有效率的差异有统计学意义(2=22.676,P=0.00);两组患者感染发生情况、副反应疗效、患者自我体检比较,其差异均有统计学意义(P<0.05)。结论醋酸钙联合高通量低钙透析治疗尿毒症有助于稳定患者的血钙水平,且降低血磷和i PTH水平,不良反应少,对于预防高磷血症以及心血管并发症具有积极意义。

Objective To Investigate the effect of calcium acetate combined with high-flux and low-calcium dialysis on blood calcium and phosphorus levels in hyperphosphatemia in uremic patients and clinical efficacy. Methods From July 2013 to June 2015,126 patients with uremia admitted to our hospital were divided into control group and experimental group according to admissions and double days,with 63 cases in each group. Both groups were given hemodialysis treatment. The control group received oral calcium carbonate tablets one tablet at a time and 3 times a day. The experimental group received oral calcium acetate,two tablets at a time,and three times daily. The statistical differences in blood calcium,phosphorus,and parathyroid hormone levels before and after treatment were compared between the two groups. Results The differences in hemoglobin,plasma albumin,calcium and phosphorus,calcium and alkaline phosphatase contents were statistically significant（ P〈0. 05） after treatment for 30 days and 60 days after treatment. In the two groups,there was a statistically significant difference in blood phosphorus,blood calcium and i PTH content（ P〈0. 05）. The difference in treatment efficiency between the two groups was statistically significant（ x^2= 22. 676,P = 0. 00）. There were statistically significant differences in the incidence of infection,side effects,and patient self-examinations between the two groups（ P〈0. 05）. Conclusions Calcium acetate joint high flux of low calcium dialysis in patients with uremia help stabilize blood calcium levels,and reduce the blood level of phosphorus and i PTH,less adverse reaction,to prevent hyperphosphatemia and cardiovascular complications has positive significance.