碳酸镧结合高通量透析对慢性肾脏病矿物质与骨代谢紊乱的影响

Effect of lanthanum carbonate combined with high-flux dialysis on chronic kidney disease mineral and bone metabolic disorders

目的探讨分析碳酸镧结合高通量透析对慢性肾脏病患者矿物质与骨代谢紊乱的影响。方法选择慢性肾衰竭且维持性血液透析1年以上患者84例作为研究对象,根据患者透析方式和药物服用情况将患者分为观察组(高通量血液透析与碳酸镧组)、对照组(低通量血液透析与碳酸钙组)。比较两组患者治疗6个月后血清钙、磷、全段甲状旁腺激素(iPTH)及血管钙化评分情况。结果透析6个月后,观察组患者的钙、磷及iPTH水平均优于对照组(P<0.05);观察组患者冠状动脉钙化积分(CACS)值明显低于对照组(P<0.05);观察组血红蛋白、血清尿素、肌酐、血清白蛋白变化幅度更大(P<0.05);两组消化道不良反应发生率比较,差异无统计学意义(P>0.05)。结论碳酸镧结合高通量透析能够有效改善维持性血液透析患者钙、磷紊乱、iPTH水平及冠状动脉血管钙化程度。

Objective To analyze the effects of lanthanum carbonate combined with high-flux dialysis on mineral and bone metabolic disorders in patients with chronic kidney disease.Methods Eighty-four patients who had been on maintenance hemodialysis for chronic kidney disease were selected as subjects,patients were divided into observation group(high-flux hemodialysis and Lanthanum Carbonate Group)and control group(low-flux hemodialysis and calcium carbonate group).Serum Calcium,phosphorus,total Parathyroid hormone and vascular calcification scores were compared between the two groups after 6 months of treatment.Results After 6 months,the level of calcium,phosphorus and Parathyroid hormone in the observation group was better than controls(P<0.05).The calcification score of coronary artery in the observation group was significantly lower than controls(P<0.05).The magnitude of the variability of hemoglobin,Serum Urea,creatinine and ALB in the observation group were higher than controls(P<0.05).There was no significant difference in the incidence of digestive tract adverse reactions between the two groups(P>0.05).Conclusion Lanthanum carbonate combined with high-flux dialysis can effectively improve calcium and phosphorus disturbance,total Parathyroid hormone level and coronary artery calcification in maintenance hemodialysis patients,which is worthy of clinical promotion.