讨论腹膜透析和血液透析对终末期肾病患者血清钙磷、iPTH水平的影响

Effects of Peritoneal Dialysis and Hemodialysis on Serum Calcium,Phosphorus and iPTH Levels in Patients with ESRD

目的:探讨腹膜透析(PD)和血液透析(HD)对终末期肾病(ESRD)患者钙磷代谢及甲状旁腺功能紊乱情况的影响。方法:选取2021年1-12月普洱市人民医院肾内科收治的240例ESRD患者为研究对象。根据透析方式分为PD组(127例)和HD组(113例),PD组给予持续性不卧床腹膜透析(CAPD)治疗,HD组予HD治疗,收集两组的血钙、血磷、碱性磷酸酶(ALP)、甲状旁腺激素(iPTH),比较两组血钙、血磷、ALP、iPTH水平血钙、血磷、iPTH达标率。结果:PD组iPTH显著高于HD组(P<0.05),而血钙显著低于HD组(P<0.05),HD组的血磷、ALP略高于PD组,差异无统计学意义(P>0.05);HD组血钙达标率明显高于PD组(P<0.05);两组血磷、iPTH达标情况比较,PD组略低于HD组,差异无统计学意义(P>0.05)。结论:HD的血钙达标率优于PD,但两种方法的血磷、iPTH达标率基本相当。对于医疗资源缺乏的边境地区的ESRD患者来说,PD与HD的治疗方式同等重要。

Objective:To investigate the effects of peritoneal dialysis(PD)and hemodialysis(HD)on calcium and phosphorus metabolism and parathyroid dysfunction in patients with end stage renal disease(ESRD).Method:A total of 240 patients with end stage renal disease treated in the Department of Nephrology of Pu’er People’s Hospital from January to December 2021 were selected as the research object.They were divided into PD group(127 cases)and HD group(113 cases)according the dialysis method.PD group was treated with CAPD and HD group was treated with HD.The blood calcium,blood phosphorus,alkaline phosphatase(ALP)and parathyroid hormone(iPTH)of the two groups were collected.The levels of blood calcium,blood phosphorus,ALP,iPTH,and standard rates of blood calcium,blood phosphorus,iPTH were compared between the two groups.Result:iPTH in PD group was significantly higher than that in HD group(P<0.05),while blood calcium was significantly lower than that in HD group(P<0.05),blood phosphorus and ALP in HD group were slightly higher than those in PD group,there were no significant differences(P>0.05).The standard rate of blood calcium in HD group was significantly higher than that in PD group(P<0.05).The standard rates of blood phosphorus and iPTH in PD group were slightly lower than those in HD group,there were no significant differences(P>0.05).Conclusion:The standard rate of blood calcium of HD is better than that of PD,but there are no significant differences in the standard rate of blood phosphorus and iPTH between the two methods.The treatment of PD and HD is equally important for ESRD patients in border areas where medical resources is scarce.