摘要
目的探讨复方α-酮酸联合碳酸钙D3对维持性血液透析患者血清白蛋白（ALB）、碱性磷酸酶（AKP）水平变化及生活质量的影响。方法选取2014年12月至2017年3月87例在本院行维持性血液透析的终末期肾病（ESRD）患者，按照随机数表法分为观察组44例与对照组43例。两组均行常规维持性血液透析治疗（4h／次，3次，周），在此基础上，对照组给予复方α-酮酸治疗，观察组给予复方α-酮酸联合碳酸钙D3治疗，疗程均为3个月。对比两组治疗前后钙磷代谢情况（血钙、血磷、钙磷乘积）及血清ALB、AKP水平、营养状态（SGA）评分、生活质量（SF-36）评分、用药期间不良反应发生率比较。结果治疗前，两组血钙、血磷水平及钙磷乘积、血清ALB、AKP水平比较，差异无统计学意义（P〉0．05）；治疗后两组血钙、血磷水平及钙磷乘积、血清ALB、AKP水平较治疗前均有改善，差异有统计学意义（P〈0．05），两组血钙水平无显著差异（P〉0．05），观察组血磷水平、钙磷乘积及AKP较对照组低，ALB较对照组高，差异有统计学意义（P〈0．05）；观察组与对照组不良反应发生率分别为：异常代谢（4．55％、2．33％）、高钙血症（6．82％、4．65％）、恶心／呕吐（6．82％、9．30％）、便秘（6．82％、4．65％），组间比较差异无统计学意义（P〉0．05）；治疗前，两组SGA评分、SF-36评分比较，差异无统计学意义（P〉0．05）；治疗后两组SGA评分、SF-36评分较治疗前均有改善，观察组较对照组高，差异有统计学意义（P〈0．05）。结论给予维持性血液透析患者复方α-酮酸联合碳酸钙D3治疗，可有效纠正钙磷代谢紊乱，改善血清ALB、AKP水平，且具有一定安全性，有利于改善患者生活质量。
Objective To investigate the effects of compound alpha keto acid combining calcium carbonate D3 on serum levels of albumin （ALB） and alkaline phosphatase （AKP） and quality of life in patients undergoing maintenance hemodialysis. Methods 87 patients with end-stage renal disease （ESRD） undergoing maintenance hemodialysis from December 2014 to March 2017 at our hospital were selected and randomly divided into an observation group （n=44） and a control group （n=43）. Both groups were routinely treated with maintenance hemodialysis, 4 h/time, 3 times/week. In addition, the control group were treated with compound alpha keto acid, while the observation group with compound alpha keto acid and calcium carbonate D3. The treatment course was 3 months. The calcium and phosphorus metabolism situation （phosphorus, calcium, and phosphorus products） and serum levels of ALB and AKP, nutritional status （SGA） score, quality of life （SF-36） score, and the incidence of adverse reactions during medication were compared between the two groups before and after the treatment. Results Before the treatment, there were no statistical differences in blood calcium and phosphorus, calcium-phosphorus product, and serum levels of ALB and AKP between the two groups （all P 〉 0.05）. After the treatment, the blood calcium and phosphorus levels, calcium-phosphorus product, and serum levels of ALB and AKP were improved in the two groups （P 〈 0.05）. There was no statistical difference in serum calcium levels between the two groups （P 〉0.05）. The phosphorus level, calcium-phosphorus product, and AKP were lower and the ALB was higher in the observation group than in the control group （P 〈 0.05）. The incidences of abnorrnal metabolism, hypercalcemia, nausea/vomiting, and constipation were 4.55%, 6.82%, 6.82%, and 6.82% in the observation group and were 2.33%, 4.65%, 9.30%, and 4.65% in the control group, respectively, with no statistical differences （P 〉0.05）. Before the treatment, there were no statistical differences in the scores of SGA and SF-36 between the two groups （P 〉0.05）. The scores of SGA and SF-36 were better after than before the treatment in both groups （P〈0.05） and were so in the observation group than in the control group after the treatment （P〈0.05）. Conclusion Compound alpha keto acid combining calcium carbonate D3 for patients undergoing maintenance hemodialysis is effective and safe and can effectively correct the disorder of calcium and phosphorus metabolism and improve the serum levels of ALB and AKP and the patients＇ quality of life.
出处
《国际医药卫生导报》
2018年第4期569-573,共5页
International Medicine and Health Guidance News
