摘要
目的探讨低钙腹膜透析液(LCD)对慢性肾衰竭(CRF)患者钙磷代谢及全段甲状旁腺激素(iPTH)水平的影响。方法选取2015年2月-2018年12月邯郸市中心医院肾内科收治的CRF患者128例,均接受透析治疗并完成随访,其中连续采用标准钙腹膜透析液(SCD)透析>12个月的62例患者作为SCD组,连续采用LCD透析>12个月的66例患者作为LCD组。比较两组患者透析前及透析后4周、12个月钙离子浓度、磷离子浓度、钙磷乘积、血清iPTH水平及达标率,并观察LCD组患者随访1年并发症发生情况及预后。结果(1)时间与方法在钙离子浓度、磷离子浓度、钙磷乘积上存在交互作用(P<0.05);时间在钙离子浓度、磷离子浓度、钙磷乘积上主效应显著(P<0.05),方法在钙离子浓度上主效应显著(P<0.05),方法在磷离子浓度、钙磷乘积上主效应不显著(P>0.05);LCD组患者透析12个月钙离子浓度、磷离子浓度低于SCD组,钙磷乘积小于SCD组(P<0.05)。(2)时间与方法在血清iPTH水平上无交互作用(P>0.05),时间、方法在血清iPTH水平上主效应不显著(P>0.05);两组患者透析前及透析4周、12个月iPTH达标率比较,差异无统计学意义(P>0.05)。(3)LCD组患者随访期间无一例出现低钙血症、抽搐、低血压、肌肉疼痛及心血管事件、死亡等。结论LCD可有效改善CRF患者钙磷代谢,有利于维持患者血清PTH水平及甲状旁腺功能稳定,且安全性较高。
Objective To investigate the impact of low calcium dialysate(LCD)on calcium-phosphorus metabolism and serum intact parathyroid hormone(iPTH)level in patients with chronic renal failure(CRF).Methods From February2015 to December 2018,a total of 128 patients with CRF were selected in the Department of Nephrology,Handan Central Hospital,all of them were treated by dialysis and successfully followed-up,thereinto 62 cases underwent dialysis by using standard calcium dialysate(SCD)for 12 months at least were served as SCD group,while the other 66 cases underwent dialysis by using LCD for 12 months at least were served as LCD group.Ca^2+concentration,P^3+concentration,calcium-phosphorus product,serum level and control rate of iPTH were compared between the two groups before dialysis,4 weeks and 12 months after dialysis,moreover incidence of adverse reactions and prognosis during the 1-year follow-up were observed in LCD group.Results(1)There were statistically significant interaction between time and method in Ca^2+concentration,P^3+concentration and calcium-phosphorus product(P<0.05);main effect of time was statistically significant in Ca^2+concentration,P^3+concentration and calcium-phosphorus product(P<0.05);main effect of method was statistically significant in Ca^2+concentration(P<0.05);main effec of method was not statistically significant in P^3+concentration or calcium-phosphorus product(P>0.05);Ca^2+concentration,P^3+concentration and calcium-phosphorus product in LCD group were statistically significantly lower than those in SCD group 12 months after dialysis(P<0.05).(2)There was no statistically significant interaction between time and method in serum iPTH level(P>0.05),moreover main effects of time and method were not statistically significant in serum iPTH level(P>0.05);there was no statistically significant difference in control rate of iPTH between the two groups before dialysis,4 weeks or 12 months after dialysis(P>0.05).(3)No one in LCD group occurred hypocalcemia,convulsion,hypotension,muscular pain,cardiovascular events or death during 1-year follow-up.Conclusion LCD can effectively improve the calcium-phosphorus metabolism,is helpful to maintain the stability of serum iPTH level and parathyroid function,and is relatively safe.
作者
李芸
郑朝霞
段丽萍
LI Yun;ZHENG Chaoxia;DUAN Liping(The First Department of Nephrology,Handan Central Hospital,Handan 056000,China)
出处
《实用心脑肺血管病杂志》
2019年第11期89-92,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
邯郸市科学技术研究与发展计划项目（1423108062-11)
关键词
肾功能衰竭
慢性
腹膜透析
低钙透析液
钙磷代谢
甲状旁腺激素
Kidney failure,chronic
Peritoneal dialysis
Low calcium dialysate
Calcium and phosphorus metabolism
Parathyroid hormone
作者简介
通信作者:郑朝霞,E-mail:ly3834930@163.com。
