血液透析和腹膜透析对终末期肾脏病患者钙磷代谢影响研究

发布时间：2018-03-05 21:37

本文选题：肾病　切入点：血液透析　出处：《中国全科医学》2017年S2期 　论文类型：期刊论文

【摘要】：目的探讨血液透析(HD)和腹膜透析(PD)对终末期肾脏病(ESRD)患者钙磷代谢的影响,为改善ESRD患者钙磷代谢紊乱提供临床依据。方法选取2012—2015年河南科技大学第一附属医院收治的HD患者276例(作为HD组)和PD患者236例(作为PD组),再将所有患者按透析龄分为5组,3~12个月组、12~24个月组、24~36个月组、36~48个月组、48个月组。分析各透析龄组患者血钙、血磷、全段甲状旁腺素、钙磷乘积,并分析HD、PD患者钙磷代谢紊乱的影响因素。结果 24~36个月组、36~48个月组、48个月组HD、PD患者血钙、血磷、甲状旁腺素比较,差异有统计学意义(P0.05);36~48个月组、48个月组HD、PD患者钙磷乘积比较,差异有统计学意义(P0.05)。年龄、透析龄、血红蛋白、三酰甘油、β_2微球蛋白、尿素清除指数(Kt/V)是PD患者钙磷代谢紊乱的影响因素(P0.05);年龄、透析龄、β_2微球蛋白、Kt/V是HD患者钙磷代谢紊乱的影响因素(P0.05)。结论 ESRD患者钙磷代谢紊乱普遍存在,与HD相比,PD患者钙磷代谢紊乱发生率相对低。提高透析充分性可改善血透和腹透患者钙磷代谢紊乱,积极改善贫血,降脂等加强一体化治疗有助于纠正HD患者钙磷代谢紊乱。
[Abstract]:Objective to investigate the effects of HD and PDD on calcium and phosphorus metabolism in patients with end-stage renal disease (ESRD). Methods 276 HD patients (as HD group) and 236 PD patients (as PD group) admitted in the first affiliated Hospital of Henan University of Science and Technology from 2012 to 2015 were selected to provide clinical basis for improving calcium and phosphorus metabolism disorder in patients with ESRD. Hemodialysis age was divided into 5 groups: 12 ~ 24 months group, 24 ~ 36 months group, 36 ~ 48 months group and 48 months group. Blood phosphorus, total parathyroid hormone, calcium and phosphorus product, and the influencing factors of calcium and phosphorus metabolism disorder in patients with HDPD were analyzed. Results the blood calcium, serum phosphorus and parathyroid hormone were compared between 24 ~ 36 months group and 48 months group of HDPD patients. There were significant differences in calcium and phosphorus products in patients with HDPD from 36 to 48 months old, age, dialysis age, hemoglobin, triacylglycerol, 尾 2 microglobulin, age, hemoglobin, triacylglycerol, 尾 2 microglobulin. Urea clearance index (KT / V) is the influential factor of calcium and phosphorus metabolism disorder in PD patients (P 0.05), age, dialysis age, 尾 2 microglobulin K / V is the influencing factor of HD patients' calcium and phosphorus metabolism disorder (P 0.05). Conclusion calcium and phosphorus metabolism disorder is common in ESRD patients. The incidence of calcium and phosphorus metabolic disorder in PD patients was lower than that in HD patients. Improving dialysis adequacy could improve calcium and phosphorus metabolism disorders in hemodialysis and peritoneal dialysis patients.
【作者单位】：河南科技大学临床医学院河南科技大学第一附属医院;
【分类号】：R692.5

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