血液透析滤过治疗伴有高磷血症的维持性血液透析患者疗效观察

The observation of curative effect of hemodiafiltration in the treatment of maintenance hemodialysis patients with hyperphosphatemia

目的观察伴高磷血症的维持性血液透析(MHD)患者采用血液透析滤过(HDF)治疗后,血磷、甲状旁腺激素、钙磷乘积降低的临床效果。方法 80例伴高磷血症的MHD患者,分为HDF组和HD组各40例,检测患者治疗前及3个月后血钙、血磷、钙磷乘积和PTH水平。结果与治疗前比较,治疗3个月后HDF组血磷、钙磷乘积、PTH明显下降(P <0. 05),血钙无明显变化(P> 0. 05); HD组血磷、钙磷乘积及PTH下降不明显(P> 0. 05),血钙降低(P <0. 05)。治疗3个月后,与HD组比较,HDF组血磷、钙磷乘积及PTH显著下降(P <0. 05)。结论 HDF是一种能更有效地清除血磷和PTH、降低钙磷乘积的方法。

Objective To observe tJie curative effect of hemodiafiltation(HDF)for reduction of serum phosphate,parathyroid hormone(PTH)and product of calcium and phosphorus in maintenance hemodialysis(MHD)patients with hyperphosphatemia.Methods Eighty MHD patients with hyperphosphatemia in Meishan People’s Hospital were randomly divided into HDF or hemodialysis(HD)group,40 in each group.Serum phosphorus,calcium,parathyroid hormone,product of calcium and phosphorus were measured before treatment and after 3 months of treatment.Results Compared with before treatment,after 3 months of treatment,serum levels of phosphate,calcium-phosphorus product and PTH in the HDF group were obviously decreased(P<0.05),but serum level of calcium had no change(P>0.05).In the HD group,the serum levels of phosphorus,calcium-phosphorus product and PTH were not decreased obviously(P>0.05),but serum calcium was declined(P<0.05).Compared with the HD group,after 3 months of treatment,phosphorus,calcium-phosphorus product and PTH were decreased significantly in the HDF group(P<0.05).Conclusion In comparison with HD,HDF may be an effective method for clearing serum phosphate and PTH and decreasing calcium-phosphorus product in MHD patients with hyperphosphatemia.