生理钙腹膜透析液对钙磷代谢达标及血管钙化影响的研究

发布时间：2018-05-02 07:07

  本文选题：腹膜透析 + 生理钙　； 参考：《东南大学学报(医学版)》2017年06期

【摘要】：目的:探讨生理钙腹膜透析对患者钙磷代谢紊乱和心血管钙化的影响。方法:2009年1月至2015年6月在我院规律随访大于12个月的134例腹膜透析患者,根据使用透析液钙离子浓度不同分为高钙透析组、生理钙透析组。比较患者治疗12个月前后的钙磷代谢情况、心脏超声及血管钙化等相关指标。结果:71例高钙透析组患者在治疗12个月后,其血钙水平显著高于使用生理钙透析组的58例患者(P0.01)。高钙透析组患者在治疗12个月后,其血钙、冠脉积分、腹主动脉积分水平较基线水平升高程度显著高于生理钙透析组患者(P0.05)。5例患者随访中由高钙透析液转为生理钙透析液,在更换为生理钙透析液治疗12个月后,患者血钙显著降低、iPTH明显升高(P0.05)。与高钙透析组患者比较,生理钙透析组和高钙转生理钙透析组患者在治疗12个月后,活性维生素D的使用和血钙达标的比例显著高于前者(P0.05)。高钙转生理钙透析液的5例患者在改用生理钙透析液后患者的iPTH达标率显著增加(P0.05)。结论:与高钙透析液相比,使用生理钙透析液有利于维持腹膜透析患者血钙的达标,改善iPTH代谢,并延缓血管钙化的进程。
[Abstract]:Objective: to investigate the effect of physiological calcium peritoneal dialysis on calcium and phosphorus metabolism disorder and cardiovascular calcification. Methods: from January 2009 to June 2015 134 peritoneal dialysis patients who were followed up regularly for more than 12 months were divided into high calcium dialysis group and physiological calcium dialysis group according to the calcium ion concentration of dialysate. Calcium and phosphorus metabolism, cardiac ultrasound and vascular calcification were compared before and after 12 months treatment. Results after 12 months of treatment, the serum calcium level of 71 cases of high calcium dialysis group was significantly higher than that of 58 cases of physiological calcium dialysis group (P 0.01). After 12 months of treatment, the levels of serum calcium, coronary artery score and abdominal aorta score in the high calcium dialysis group were significantly higher than those in the physiological calcium dialysis group (P 0.05). During the follow-up, the changes from high calcium dialysate to physiological calcium dialysate were observed. After 12 months of replacement with physiological calcium dialysate, the level of serum calcium decreased significantly and the level of iPTH increased significantly (P 0.05). Compared with the high calcium dialysis group, the ratio of active vitamin D use and blood calcium standard in physiological calcium dialysis group and high calcium to physiological calcium dialysis group was significantly higher than that in the former group after 12 months treatment. The iPTH of 5 patients with high calcium to physiological calcium dialysate increased significantly (P 0.05) after using physiological calcium dialysate. Conclusion: compared with high calcium dialysate, the use of physiological calcium dialysate is beneficial to maintain the standard of blood calcium in peritoneal dialysis patients, improve the metabolism of iPTH, and delay the process of vascular calcification.
【作者单位】： 南京医科大学鼓楼临床医学院肾内科;南京大学医学院附属鼓楼医院肾内科;
【分类号】：R692.5
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本文编号：1832870