盐酸司维拉姆与低钙透析液合用对血液透析患者相关血清指标的改善效果

Effects of sevelamer hydrochloride combined with low calcium dialysate on serum highdensity lipoprotein, phosphorus, calcium-phosphate product and adverse reactions in patients undergoing hemodialysis

目的探讨盐酸司维拉姆与低钙透析液联合应用对血液透析患者血清高密度脂蛋白、血磷、血清钙磷乘积变化及不良反应的影响。方法选取医院2016-01至2018-01肾内科进行血液透析的慢性肾衰竭患者80例,分为对照组和试验组,每组40例,对两组患者采取不同的治疗方法:对照组采取常规血液透析治疗方法;试验组选用盐酸司维拉姆与低钙透析液进行联合治疗。治疗周期均为12周。治疗结束后,观察两组患者脂质代谢指标变化(TC、TG、LDL-C、HDL-C)、血钙、血磷、血清钙磷乘积变化及不良反应。结果试验组患者在治疗前后,测得其血钙浓度并无显著变化(P> 0. 05),对照组患者治疗后血钙(2. 75±0. 35) mmol/L浓度明显高于治疗前,差异有统计学意义(P <0. 05);试验组患者治疗后TC(4. 12±0. 86) mmol/L、TG(1. 21±0. 64) mmol/L、LDL-C(2. 14±0. 38 mmol/L)水平均显著低于对照组患者,而HDL-C水平(1. 54±0. 20)较对照组明显升高,差异有统计学意义(P <0. 05);患者治疗后不良反应的总发生率为31. 82%,明显高于对照组的18. 18%(P <0. 05)。结论采取盐酸司维拉姆与低钙透析液联合治疗的方式,可有效改善血液透析患者血清高密度脂蛋白、血磷、血清钙磷乘积水平,疗效显著,且基本无严重不良反应发生。

Objective To investigate the effects of sevelamer hydrochloride combined with low calcium dialysate on high-density lipoprotein, phosphorus, and calcium-phosphorus product of serum and adverse reactions in patients undergoing hemodialysis. Methods Eighty patients with chronic renal failure who underwent hemodialysis in the Department of Nephrology of our hospital between January 2016 and January 2018 were randomly divided into the control group (treated with conventional hemodialysis, n = 40) and the experimental group (treated with sevelamer hydrochloride combined with low calcium dialysate, n = 40). The course of treatments for both groups was 12 weeks. The changes of lipid metabolism indexes ( TC, TG, LDL-C, HDL-C), blood calcium, serum phosphorus, serum calcium-phosphorus product and adverse reactions in both groups were observed. Results There was no significant change in serum calcium concentrations after treatment in the experimental group ( P >0. 05 ). The serum calcium concentration (2. 75 ±0. 35) mmol/L in the control group was significantly higher after treatment ( P <0. 05). After treatment, the levels of TC (4. 12 ± 0. 86) inmol/L, TG (1.21 ± 0. 64) mmol/L and LDL-C (2. 14 ± 0. 38 ) mmol/L in the experimental group were significantly lower than those in the control group, while HDL-C was significantly higher than that in the control group (P <0.05). The total incidence of adverse reactions was 31. 82% in the experimental group, which was significantly higher than 18. 18% in the control group ( P < 0. 05 ). Conclusions Sevelamer hydrochloride combined with low calcium dialysate can significantly improve the levels of serum highdensitv lipoprotein, serum phosphorus and semm calcium-phosphorus product in patients undergoing hemodialysis, with significant curative effect but without serious adverse reactions.