發(fā)布時(shí)間：2018-05-02 07:07

  本文選題：腹膜透析 + 生理鈣��； 參考：《東南大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年06期

【摘要】：目的:探討生理鈣腹膜透析對(duì)患者鈣磷代謝紊亂和心血管鈣化的影響。方法:2009年1月至2015年6月在我院規(guī)律隨訪大于12個(gè)月的134例腹膜透析患者,根據(jù)使用透析液鈣離子濃度不同分為高鈣透析組、生理鈣透析組。比較患者治療12個(gè)月前后的鈣磷代謝情況、心臟超聲及血管鈣化等相關(guān)指標(biāo)。結(jié)果:71例高鈣透析組患者在治療12個(gè)月后,其血鈣水平顯著高于使用生理鈣透析組的58例患者(P0.01)。高鈣透析組患者在治療12個(gè)月后,其血鈣、冠脈積分、腹主動(dòng)脈積分水平較基線水平升高程度顯著高于生理鈣透析組患者(P0.05)。5例患者隨訪中由高鈣透析液轉(zhuǎn)為生理鈣透析液,在更換為生理鈣透析液治療12個(gè)月后,患者血鈣顯著降低、iPTH明顯升高(P0.05)。與高鈣透析組患者比較,生理鈣透析組和高鈣轉(zhuǎn)生理鈣透析組患者在治療12個(gè)月后,活性維生素D的使用和血鈣達(dá)標(biāo)的比例顯著高于前者(P0.05)。高鈣轉(zhuǎn)生理鈣透析液的5例患者在改用生理鈣透析液后患者的iPTH達(dá)標(biāo)率顯著增加(P0.05)。結(jié)論:與高鈣透析液相比,使用生理鈣透析液有利于維持腹膜透析患者血鈣的達(dá)標(biāo),改善iPTH代謝,并延緩血管鈣化的進(jìn)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.
【作者單位】： 南京醫(yī)科大學(xué)鼓樓臨床醫(yī)學(xué)院腎內(nèi)科;南京大學(xué)醫(yī)學(xué)院附屬鼓樓醫(yī)院腎內(nèi)科;
【分類號(hào)】：R692.5
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本文編號(hào)：1832870