摘要
目的分析低钙透析液对老年血液透析伴低转化肾性骨病患者的影响。方法将100例在维持性血液透析(MHD)的并伴有低转化肾性骨病的患者纳入研究,随机分对照组(透析液含钙量为1.5 mmol/L)和观察组(透析液含钙量为1.25 mmol/L),记录患者治疗前、治疗后3个月、6个月患者磷(P)、白蛋白矫正钙(Ac-Ca)、全段甲状旁腺激素(i PTH)、钙磷乘积(Ca×P)变化,记录不良反应情况,观察指骨X线片骨密度,统计治疗总有效率。结果治疗前两组各观察指标无显著差异(P>0.05)。观察组i PTH和Ca×P在治疗前、治疗3个月及6个月期间对比差异显著;治疗6个月时观察组Ac-Ca明显低于治疗前,差异有显著性(P<0.05)。观察组治疗6个月时i PTH水平较对照组高,Ca×P水平较对照组低,差异均有显著性(P<0.05)。观察组治疗总有效率(92.00%)较对照组(72.00%)高(P<0.05)。两组不良反应发生率无显著差异(P>0.05)。观察组X线片下指骨软组织钙化影和纤维性骨炎症影缓解更明显,较对照组情况更好。结论低钙透析液用于老年血液透析伴低转化肾性骨病患者中,能显著纠正紊乱的钙磷代谢,缓解甲状旁腺功能抑制,安全可行。
Objective To analyze the effect of low calcium dialysate for hemodialysis in patients with renal osteodystrophy.Methods A total of 100 patients with maintenance hemodialysis(MHD) were enrolled in this study.They were randomly divided into control group(with 1.5 mmol/L calcium in dialysate) and observation group(with 1.25 mmol/L calcium in dialysate).The change in blood levels of phosphorus(P),albumin-corrected calcium(Ac-Ca),total parathyroid hormone(i PTH) and product of P and Ca(P-Ca) had been measured before treatment and in 3 months and 6 months after treatment in observation group(1.25 mmol/L calcium in dialysate)(IPTH),and the products of calcium and phosphorus(Ca × P) were recorded.The adverse reactions were recorded in patients of both 2 groups.The bone density of phalanx was examined by X-ray and the total effective rate in patients of these 2 groups was calculated.Results There was no difference in observed indicesbetween these two groups before treatment(P > 0.05).The difference in levels of i PTH and Ca × P between observation group and control group was significant before treatment,and 3 months and 6 months after treatment.Level of Ac-Ca in observation group was significantly different from that before treatment at 6 months.The level of i PTH in observation group was higher than that of control group at 6 months,and the level of Ca ×P was lower in observation group than that of control group.The total effective rate of observation group(92.00%) was higher than that of control group(72.00%)(P < 0.05).There was no significant difference in incidence of adverse reactions between these two groups(P > 0.05).The calcification shadow in finger soft tissue and fibrous alleviate bone inflammation shadow under X-ray were more obvious in observation group,and they were more better than those of control group.Conclusion Low calcium dialysate can be used in elderly hemodialysis patients with low transforming renal osteodystrophy,and it can significantly correct the disorder in calcium and phosphorus metabolism,alleviate the inhibition of parathyroid function,hence it is safe and feasible.
出处
《临床和实验医学杂志》
2018年第3期314-317,共4页
Journal of Clinical and Experimental Medicine
关键词
老年人
血液透析
低钙透析液
低转化肾性骨病
Elderly
Hemodialysis
Low calcium dialysate
Low conversion renal osteodystrophy
