腹膜透析与血液透析对尿毒症患者钙磷代谢的影响探究

Effects of Peritoneal Dialysis and Hemodialysis on Calcium and Phosphorus Metabolism in Patients with Uremia

目的分析和讨论腹膜透析(peritoneal dialysis,PD)与血液透析(hemodialysis,HD)对尿毒症患者钙磷代谢的影响。方法随机选取2019年2月—2021年3月龙岩市第二医院收治的150例尿毒症透析患者,以随机抽样法将患者分对照组(采用HD治疗)和研究组(采用PD治疗),各75例,针对两组患者炎症因子,钙、磷和甲状旁腺激素代谢异常率,以及治疗6个月后钙、磷和甲状旁腺激素水平进行对比。结果研究组治疗3个月后、6个月后的hs-CRP、IL-6水平均低于对照组,差异有统计学意义(t=17.700、35.649、6.524、15.791,P<0.05);治疗6个月后,观察组高磷和高甲状旁腺激素代谢异常率分别为21.33%、22.67%,均低于对照组的66.67%、61.33%,差异有统计学意义(χ^(2)=31.277、23.016,P<0.05);治疗6个月后,研究组钙水平(2.26±0.21)mmol/L高于对照组的(2.03±0.23)mmol/L,磷和甲状旁腺激素水平分别为(1.61±0.59)mmol/L、(165.52±60.85)pg/mL,均低于对照组的(1.96±0.65)mmol/L、(197.59±67.04)pg/mL,差异有统计学意义(t=6.396、3.453、3.068,P<0.05)。结论PD在尿毒症治疗中相较HD,可以更有效地清除患者体内的炎症因子,且PD在控制患者钙磷代谢水平方面优于HD。

Objective To analyze and discuss the effects of peritoneal dialysis(PD)and hemodialysis(HD)on calcium and phosphorus metabolism in patients with uremia.Methods 150 uremic dialysis patients admitted to the Longyan Second Hospital from February 2019 to March 2021 were randomly selected,they were divided into the control group(with HD treatment)and the study group(with PD treatment)by random sampling,with 75 cases in each group.The inflammatory factors,abnormal rates of calcium,phosphorus and parathyroid hormone metabolism,and the levels of calcium,phosphorus and parathyroid hormone after 6 months of treatment were compared between the two groups.Results The levels of hs-CRP and IL-6 in the study group after 3 months and 6 months of treatment were lower than those in the control group,and the differences were statistically significant(t=17.700,35.649,6.524,15.791,P<0.05);after 6months of treatment,the abnormal rates of hyperphosphorus and hyperparathyroid hormone metabolism in the observation group were 21.33%and 22.67%,respectively,which were lower than those in the control group,66.67%and 61.33%,and the differences were statistically significant(χ^(2)=31.277,23.016,P<0.05);after 6 months of treatment,the calcium level in the study group was(2.26±0.21)mmol/L higher than that in the control group(2.03±0.23)mmol/L;the levels of phosphorus and parathyroid hormone in the study group were(1.61±0.59)mmol/L and(165.52±60.85)pg/mL,respectively,which were lower than those in the control group(1.96±0.65)mmol/L and(197.59±67.04)pg/mL,the difference was statistically significant(t=6.396,3.453,3.068,P<0.05).Conclusion Compared with HD in the treatment of uremia,PD can more effectively remove inflammatory factors in patients,and PD is better than HD in controlling the level of calcium and phosphorus metabolism in patients.