摘要
目的探讨低钙(1.25mmol/L)透析液在维持性血液透析(maintenance hemodialysis,MHD)患者中的应用及其对血钙、血磷和全段甲状旁腺激素(intact parathyroid hormone,iPTH)控制效果。方法通过检索中国知网、万方数据、维普、中国生物医学文献数据库和PubMed数据库,对近10年内关于低钙透析液在MHD患者中的临床应用研究进行Meta分析,比较低钙透析液组(low calcium dialysate,LCD组)和1.5 mmol/L钙浓度透析液组(high calcium dialysate,HCD组)血钙、血磷和iPTH水平的变化。结果共纳入11篇国内外文献。Meta分析结果显示,LCD组血钙水平显著低于HCD组(SMD=-0.679, 95%CI:-1.157～-0.202,P=0.005),2种透析液降磷效果无显著差异(SMD=-0.824,95%CI:-1.733～0.085,P=0.076),LCD组iPTH水平高于HCD组(SMD=1.235,95%CI:0.555～1.915,P<0.001)。结论低钙透析可降低患者的血钙和磷水平,可致iPTH水平升高;标准透析可致血钙上升,血磷下降,iPTH水平稳定波动;2种透析液降磷效果无显著差异。
Objective To study the application of low calcium dialysate(1.25 mmol/L) in maintenance hemodialysis(MHD) patients and survey its clinical effects on serum calcium(Ca), phosphate(P) and intact parathyroid hormone(iPTH). Methods By search of publications in the last 10 years in CNKI, Wanfang China Science Periodical Database(CSPD), VIP China Science and Technology Journal Database(CSTJ),SinoMed database and PubMed database, a meta-analysis was performed using the publications about the clinical application of low calcium dialysate in MHD patients, and the levels of serum calcium, phosphate and iPTH were then compared between MHD patients using low calcium dialysate(LCD) and calcium 1.5 mmol/L dialysate(HCD). Results Eleven publications were included in the meta-analysis. Serum Ca level in patients using LCD was lower than that in those using HCD(SMD=-0.679, 95% CI-1.157^-0.202, P=0.005).Serum P had no significantly difference between patients using LCD and those using HCD(SMD=-0.824,95% CI-1.733~0.085, P=0.076). iPTH level was significant higher in patients using LCD than in those using HCD(SMD=1.235, 95% CI 0.555~1.915, P<0.001). Conclusion LCD can decrease the levels of serum Ca and P and increase the level of iPTH, while HCD can increase the level of serum Ca, decrease the level of serum P, and have no significant effect on iPTH. These two kinds of dialysate have similar effect on the decrease of serum P.
作者
黄盈
HUANG Ying(Hemodialysis Division,General Hospital of Southern Theatre Command,Guangzhou 510010,China)
出处
《中国血液净化》
CSCD
2019年第1期21-25,共5页
Chinese Journal of Blood Purification
关键词
低钙透析
血钙
血磷
IPTH
META分析
Low calcium dialysate
Serum calcium
Serum phosphate
iPTH
meta-analysis
作者简介
通讯作者:黄盈,Email:huangy_sci@163.com.
