低钙透析联合磷结合剂对血液透析患者钙磷代谢紊乱和冠状动脉钙化的影响

发布时间：2019-08-05 16:08

【摘要】：目的探讨低钙透析联合磷结合剂对血液透析患者钙磷代谢紊乱和冠状动脉钙化的影响。方法 80例伴冠状动脉血管钙化并行维持性血液透析(MHD)患者按照随机数字表法分为对照组和研究组各40例;对照组采取标准钙透析液及醋酸钙口服治疗,研究组采取低钙透析联合醋酸钙治疗,两组均进行12个月治疗;治疗前、治疗3、6、12个月后对血清钙、磷、甲状旁腺素进行检测,并采用螺旋CT对冠状动脉钙化积分进行检查。结果两组治疗前血清钙、磷及甲状旁腺素水平比较无明显差异(P0.05)。研究组治疗3、6、12个月后血清钙及磷水平均明显低于对照组,而甲状旁腺素水平明显高于对照组(P0.05);两组治疗前冠状动脉钙化积分比较无明显差异(P0.05);研究组治疗3、6、12个月后冠状动脉钙化积分均明显低于对照组(P0.05)。结论低钙透析联合含钙的磷结合剂可有效纠正钙磷代谢紊乱,延缓冠状动脉钙化进展,有效降低甲状旁腺功能亢进的发生率,适用于伴冠状动脉血管钙化的血液透析患者。
[Abstract]:Objective to investigate the effect of low calcium dialysis combined with phosphorus binder on calcium and phosphorus metabolism disorder and coronary artery calcification in hemodialysis patients. Methods 80 patients with coronary artery calcification and maintenance hemodialysate (MHD) were randomly divided into control group (n = 40) and study group (n = 40). The control group was treated with standard calcium dialysate and calcium acetate, and the study group was treated with low calcium dialysis combined with calcium acetate for 12 months. Before treatment, serum calcium, phosphorus and parathyroid hormone were measured 12 months after treatment, and coronary artery calcification score was examined by spiral CT. Results there was no significant difference in serum calcium, phosphorus and parathyroxine levels between the two groups before treatment (P 0.05). After treatment for 3, 6, 12 months, serum calcium and phosphorus in the study group were significantly lower than those in the control group, while parathyroid hormone levels were significantly higher than those in the control group (P 0.05). There was no significant difference in coronary artery calcification score between the two groups before treatment (P 0.05). The coronary artery calcification scores in the study group were significantly lower than those in the control group after 3, 6 and 12 months of treatment (P 0.05). Conclusion low calcium dialysis combined with calcium containing phosphorus binder can effectively correct the disorder of calcium and phosphorus metabolism, delay the progress of coronary artery calcification, and effectively reduce the incidence of hyperparathyrothyroidism. It is suitable for hemodialysis patients with coronary artery calcification.
【作者单位】：核工业416医院成都医学院第二附属医院肾内科;
【分类号】：R459.5

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