血液净化方式对维持性血液透析患者钙磷代谢的影响

Influence of blood purification for calcium and phosphorus metabolism of maintenance hemodialysis patients

目的:前瞻性研究血液透析、血液透析+血液灌流、血液透析+血液透析滤过3种不同血液净化方式对维持性血液透析患者血清PTH、钙、磷的临床疗效的影响。方法:46例维持性血液透析患者随机分为血液透析组15例,血液灌流组15例和血液透析滤过组16例。观察3组试验前(0个月)、治疗6个月后血清钙、磷、PTH水平变化。结果:血液透析组试验前(0个月)与治疗6个月后钙、磷、PTH水平无明显变化(P>0.05);血液透析滤过组、血液灌流组试验前(0个月)与治疗6个月后钙、磷、PTH测定水平比较,磷及PTH水平下降,钙水平升高(P<0.05)。结论:血液透析滤过和血液灌流两种血液净化方式比血液透析能较好改善维持性血液透析患者矿物质及钙磷代谢紊乱,提高患者生活质量。

Objective:To prospective study of hemodialysis,hemoperfusion and hemodialysis,hemodialysis and hemodiafiltration about 3 different ways of blood purification on clinical curative effect of maintenance hemodialysis patients with serum PTH,calcium,phosphorus.Methods:We selected 46 cases of maintenance hemodialysis patients.These patients were randomly divided into hemodialysis group with 15 cases,the blood perfusion group with 15 cases,and hemodiafiltration group with 16 cases.Before the experiment(0 months),6 months after treatment the changes of serum calcium,phosphorus,PTH levels were compared.The changes of serum calcium,phosphorus,PTH levels before the experiment(0 months)and 6 months after treatment were compared.Results:In hemodialysis group,there were no significant changes of calcium,phosphorus,PTH levels before the experiment(0 months)and 6 months after treatment(P>0.05);In Hemodiafiltration group and hemoperfusion group,calcium,phosphorus,PTH levels before the test(0 months)were compared with 6 months after treatment,phosphorus and PTH levels were reduced,calcium levels were elevated(P<0.05).Conclusion:Compared with hemodialysis,hemoperfusion and hemodiafiltration can improve the disorder of mineral metabolism and calcium and phosphorus in maintenance hemodialysis patients,and improve patient quality of life.