高通量维持性血液透析对CRF患者血清钙、磷、甲状旁腺激素的影响及安全性分析

发布时间：2018-06-18 20:53

本文选题：肾功能衰竭 + 终末期肾脏病　；参考：《山东医药》2017年44期

【摘要】：目的对比分析高通量和低通量维持性血液透析对肾功能衰竭(CRF)患者钙磷代谢、甲状旁腺激素(iPTH)的影响及其安全性。方法将CRF患者160例随机分为高通量组和低通量组,各80例。高通量组给予高通量维持性血液透析,低通量组给予低通量维持性血液透析,每次透析时间为4 h,3次/周,连续透析6个月。透析前及透析6个月,采用全自动生化分析仪检测两组血清钙、磷水平,采用放射免疫法检测血清iPTH,计算两组透析6个月血清钙、磷、iPTH达标率。记录两组透析期间营养不良、贫血、心血管事件发生情况及生存情况,采用SF-36量表评价两组透析前及透析6个月的生活质量。结果高通量组与低通量组透析前后血清钙水平比较差异均无统计学意义(P均0.05)。高通量组与低通量组透析6个月血清磷及iPTH水平均低于透析前,但高通量组降低更明显(P均0.05)。高通量组透析6个月血清钙、磷、iPTH达标率均高于低通量组(P均0.05)。高通量组透析期间发生营养不良4例、贫血6例、心血管事件1例,并发症发生率为13.75%,低通量组分别为17、15、4例及45.00%;高通量组并发症发生率低于低通量组(P0.05)。两组透析期间均无死亡患者。两组透析6个月SF-36量表评分均高于透析前,且高通量组升高更明显(P均0.05)。结论高通量维持性血液透析对CRF患者钙磷代谢及iPTH水平的调节效果均优于低通量维持性血液透析,并有助于提高患者的生存质量,安全性较高。
[Abstract]:Objective to compare the effects and safety of high throughput and low flux maintenance hemodialysis on calcium and phosphorus metabolism and parathyroid hormone (iPTH) in patients with renal failure (CRF). Methods 160 patients were randomly divided into high flux group and low flux group, each of 80 cases. High flux group was given high flux maintenance hemodialysis, low flux group was given low pass. The duration of maintenance hemodialysis was 4 h, 3 times per week, continuous dialysis for 6 months. Before dialysis and 6 months of dialysis, the serum calcium and phosphorus levels in two groups were detected by automatic biochemical analyzer. The serum iPTH was detected by radioimmunoassay. The serum calcium, phosphorus, and iPTH standard rate of the two groups were calculated for 6 months, and the malnutrition and poverty during the dialysis were recorded in two groups. The SF-36 scale was used to evaluate the quality of life of two groups before dialysis and 6 months of dialysis. Results there was no significant difference in serum calcium levels between high flux group and low flux group before and after dialysis (P 0.05). The level of serum phosphorus and iPTH in high flux group and low flux group was lower than that of dialysis for 6 months. The high throughput group decreased more significantly (P 0.05). The level of serum calcium, phosphorus, and iPTH in high flux groups was higher than the low flux group (P 0.05) for 6 months. 4 cases of malnutrition, 6 anemia, 1 cardiovascular events, 13.75% complications, low flux group 17,15,4 and 45%, and high flux group complications. The incidence was lower than the low flux group (P0.05). There was no death in the two groups during dialysis. The scores of the two groups were higher than those before dialysis, and the high flux group increased significantly (P 0.05). Conclusion high throughput maintenance hemodialysis has better effect on calcium and phosphorus metabolism and iPTH levels in CRF patients than in low flux maintenance hemodialysis. Help to improve the quality of life of patients, high security.
【作者单位】：内江市第二人民医院;西南医科大学;
【分类号】：R692.5

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