高通量透析联合血液灌流对血清钙、磷及甲状旁腺激素代谢的影响

Effects of high flux dialysis combined with hemoperfusion on serum calcium,phosphorus and parathyroid hormone metabolism in middle-aged and elderly patients with maintenance hemodialysis

目的分析高通量透析联合血液灌流对中老年维持性血液透析患者血清钙、磷及甲状旁腺激素代谢的影响。方法选取蚌埠市第一人民医院2015年2月~2018年7月收治的中老年维持性血液透析患者119例,按入院顺序分为观察组(60例)与对照组(59例),对照组患者采用高通量透析治疗,观察组联合血液灌流治疗,比较两组患者治疗前后血清钙(Ca)、磷(P)和甲状旁腺激素(iPTH)变化情况,以及肾功能改善情况。结果治疗后,观察组血清iPTH、P表达水平显著低于对照组,差异有统计学意义(t=14.281,5.746,P<0.05);而两组患者血清Ca表达水平比较差异无统计学意义(P>0.05)。治疗前后血清BUN和Cr水平组间比较差异无统计学意义(P>0.05)。治疗过程中两组患者均无严重不良反应发生,治疗后观察组2例患者发生低血糖,不良反应发生率比较差异无统计学意义(P>0.05)。结论高通量透析联合血液灌流对中老年维持性血液透析患者血清P和iPTH降低作用显著,但高通量透析是否联合血液灌流对血Ca变化无显著影响。

Objective To investigate the effects of high flux dialysis combined with hemoperfusion on serum calcium,phosphorus and parathyroid hormone metabolism in middle-aged and elderly patients with maintenance hemodialysis. Methods 119 middle-aged and elderly patients with maintenance hemodialysis admitted to our hospital from February 2015 to July 2018 were selected for the study. They were divided into observation group and control group according to admission order,the control group was treated with high-flux dialysis,while the observation group was treated with hemoperfusion combined with high-flux dialysis. The changes of serum calcium(Ca),phosphorus(P),parathyroid hormone(iPTH) and renal function were compared between the two groups before and after treatment. Results After treatment,the expression levels of serum iPTH and P in the observation group were significantly lower than those in the control group(P < 0.05). There was no significant difference in serum Ca expression between the two groups after treatment(P > 0.05). There was no significant difference in serum BUN and Cr levels between groups before and after treatment(P > 0.05). There were no serious adverse reactions in both groups during the course of treatment. Hypoglycemia occurred in 2 patients in the observation group after treatment. There was no significant difference in the incidence of adverse reactions between the two groups(P > 0.05). Conclusion High flux dialysis combined with hemoperfusion can significantly decrease serum P and iPTH in elderly patients with maintenance hemodialysis,but whether high flux dialysis combined with hemoperfusion has no significant effect on the changes of serum Ca.