不同通透量血液透析对老年尿毒症患者甲状旁腺激素及钙、磷代谢的影响

Comparison of Different Hemodialysis Methods on Parathyroid Hormone,Calcium and Phosphorus Metabolism in Elderly Patients with Uremia

目的探讨不同通透量血液透析对老年尿毒症患者甲状旁腺激素(PTH)及钙、磷代谢的影响。方法选取老年尿毒症88例,根据血液透析通透量不同分为低通透量透析组和高通透量透析组两组各44例。观察比较治疗前及治疗后6个月两组血PTH、钙、磷水平,血肌酐(Cr)、β2-微球蛋白(β2-MG)水平及白细胞介素6(IL-6)、C反应蛋白(CRP)水平。结果治疗后6个月高通透量透析组血PTH和磷水平显著低于治疗前,高通透量透析组血PTH及磷水平均低于低通透量透析组,差异有统计学意义(P<0.05)。治疗后6个月两组血Cr、β2-MG及IL-6、CRP水平均较治疗前降低,高通透量透析组血Cr、β2-MG及IL-6、CRP水平均低于低通透量透析组,差异有统计学意义(P<0.05)。结论老年尿毒症患者行高通透量血液透析可改善机体PTH水平及钙、磷代谢,减轻炎症反应,且有助于保护肾功能,减轻肾脏损伤。

Objective To investigate the effects of different types of flux in hemodialysis on parathyroid hormone（ PTH）,calcium（ Ca） and phosphorus（ P） metabolism in elderly patients with uremia. Methods A total of88 elderly patients with uremia admitted to our hospital from 2016 January to 2017 January were divided into low-flux hemodialysis group（ LFHD） group and high-flux hemodialysis group（ HFHD） group,with 44 cases in each group,according to different types of fluxes in hemodialysis. PTH,Ca,P,serum creatinine（ SCr）,β2-MG,interleukin-6（ IL-6） and C reactive protein（ CRP） level were compared in two groups before treatment and at 6 months after treatment. Results After treatment,the levels of P and PTH were significantly lower in HFHD group than those before treatment（ P〈0. 05）,and the difference was statistically significant（ P〈0. 05）. Six months after treatment,the levels of SCr,β2-MG,IL-6 and CRP in the two groups were decreased compared with those before treatment（ P〈0. 05 or P〈0. 01）,and the levels of those indicators were lower in HFHD group than in LFHD group（ P〈0. 05）. Conclusion HFHD can improve the level of PTH and metabolism of Ca and P in elderly patients with uremia,ameliorate inflammatory response,protect renal function and reduce renal injury.