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华西医学  2011 

腹膜透析患者钙磷代谢紊乱临床分析

, PP. 335-337

Keywords: 腹膜透析,低钙透析液,钙磷代谢

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Abstract:

【】 目的 探讨生理钙透析液对持续性不卧床腹膜透析(CAPD)患者钙磷代谢的影响。 方法 回顾性分析2008年1月-2009年12月腹膜透析患者的钙磷指标,资料齐全的患者中使用钙浓度为1.25mmol/L的腹膜透析液(生理钙组)的患者有30例,使用钙浓度为1.75mmol/L的透析液(标准钙组)患者30例。对两组患者钙磷代谢指标进行比较。 结果 治疗前后两组的血磷、钙磷乘积和全段甲状旁腺素差异均无统计学意义(P>0.05);治疗后标准钙组血钙较前升高,差异有统计学意义(P0.05)。 结论 不同含钙浓度腹膜透析液对机体钙磷代谢的影响是不同的,在高钙、高磷、低转运骨病的腹膜透析患者中使用钙浓度为1.25mmol/L的生理钙透析液减轻了钙负荷,为临床医生使用含钙磷结合剂提供了治疗空间。【Abstract】 Objective Toinvestigatetheeffectsofphysiologicalcalciumdialysateonthecalciumandphosphorusmetabolisminpatientsundergoingcontinuousambulatoryperitonealdialysis(CAPD). Methods Weretrospectivelyanalyzedtheclinicaldataof60patientshavingundergoneCAPDinWestChinaHospitalofSichuanUniversitybetweenJanuary2008andDecember2009.Thepatientsweredividedintotwogroupswith30ineachbycalciumconcentrationofthedialysatethephysiologicalcalciumdialysategroup(1.25mmol/L)andthestandardcalciumdialysategroup(1.75mmol/L).Themetabolismindexesofcalciumandphosphorusforthetwogroupofpatientswerecompared. Results LevelsofSerumphosphate,calcium-phosphateproductandimmoreactiveparathyroidhormone(iPTH)ofallthepatientsinbothgroupsbeforeandaftertreatmentshowednosignificantdifferences(P>0.05).Serumcalciumincreasedsignificantlyinpatientstreatedwithstandardcalciumdialysate(P0.05). Conclusions Dialysatewithdifferentconcentrationsofcalciumprovidesdifferentinfluenceonthemetabolismofcalciumandphosphorus.Changingcalciumconcentrationto1.25mmol/Linthedialysatecanlowerthecalciumloadforpatientswithhypercalciumand/orhyperphosphatewithlowboneturnover,providingtreatmentspaceforclinicaldoctorstousebinderscontainingbothcalciumandphosphorus.

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