摘要
目的探讨血液透析滤过(HDF)在维持性血液透析(MHD)高磷血症治疗中的应用价值。方法选择海丰县彭湃纪念医院2017年1月至2019年4月期间治疗的70例维持性血液透析伴有高磷血症患者为研究对象,根据随机数表法将患者分为观察组和对照组各35例,对照组患者接受每周3次常规血液透析治疗,观察组患者则每周1次HDF+2次血液透析,疗程3个月。比较两组患者治疗前后的血磷(P)、血钙(Ca)、碱性磷酸酶以及钙磷乘积(Ca×P)、甲状旁腺激素(iPTH)水平的变化。结果治疗前,两组患者的血Ca、血P、碱性磷酸酶、Ca×P、iPTH水平比较差异均无统计学意义(P>0.05);治疗后,观察组与对照组患者血P及Ca×P分别为(1.57±0.21) mmol/L、(54.64±10.15) mg^2/dL^2和(2.08±0.17) mmol/L、(60.44±8.91) mg^2/d L^2,均较治疗前的(2.46±0.31) mmol/L、(68.42±14.32) mg^2/d L^2和(2.42±0.24) mmol/L、(69.03±12.78) mg^2/dL^2明显降低,且观察组下降更加明显,差异均有统计学意义(P<0.05);观察组患者治疗前后的血Ca水平比较差异无统计学意义(P>0.05),但对照组患者的血Ca则明显增高,差异有统计学意义(P<0.05);观察组患者治疗后的iPTH、碱性磷酸酶分别为(582.58±106.45) pg/mL、(142.79±30.62) mmol/L,较治疗前的(667.24±119.63) pg/mL、(184.57±46.25) mmol/L明显降低,且低于对照组治疗后的(630.92±114.24) pg/mL、(197.74±40.65) mmol/L,差异均有统计学意义(P<0.05);对照组患者治疗前后的iPTH、碱性磷酸酶无明显变化,差异均无统计学意义(P>0.05)。结论血液透析滤过可以有效治疗维持性血液透析患者的高磷血症,进而改善钙磷代谢紊乱以及继发性甲状旁腺功能亢进。
Objective To investigate the value of hemodialysis filtration(HDF)in the treatment of patients with hyperphosphatemia undergoing maintenance hemodialysis(MHD).Methods Seventy patients with hyperphosphatemia undergoing MHD who were treated in Pengpai Memorial Hospital of Haifeng County from January 2017 to April 2019 were selected as the study objects.According to the random number table,the patients were divided into two groups:the observation group and the control group,with 35 patients in each group.The control group received routine hemodialysis three times a week,and the observation group received HDF once a week and hemodialysis twice a week,both for three months.The changes of serum phosphorus,calcium,alkaline phosphatase,calcium phosphorus product(CA×P),iPTH were compared before and after treatment.Results Before treatment,there was no significant difference in the levels of Ca,P,alkaline phosphatase,CA×P,and iPTH between the two groups(P>0.05);after treatment,the levels of P and Ca×P were(1.57±0.21)mmol/L,(54.64±10.15)mg2/dL2 in the observation group and(2.08±0.17)mmol/L,(60.44±8.91)mg2/dL2 in the control group,which were significantly lower than(2.46±0.31)mmol/L,(68.42±14.32)mg2/dL2 and(2.42±0.24)mmol/L,(69.03±12.78)mg2/dL2 before treatment;the decrease in the observation group was more significant than that in the control group(P<0.05).There was no significant change in blood Ca before and after treatment in the observation group(P>0.05),but blood Ca in the control group was significantly increased after treatment(P<0.05).The iPTH and alkaline phosphatase in the observation group were(582.58±106.45)pg/mL,(142.79±30.62)mmol/L,respectively,which were significantly lower than(667.24±119.63)pg/mL and(184.57±46.25)mmol/L before treatment,and were also significantly lower than(630.92±114.24)pg/mL,(197.74±40.65)mmol/L in the control group after treatment(P<0.05).There was no significant change of iPTH and alkaline phosphatase in the control group before and after treatment(P>0.05).Conclusion Hemodialysis filtration can effectively treat patients with hyperphosphatemia undergoing maintenance hemodialysis,and then improve the disorder of calcium and phosphorus metabolism and secondary hyperparathyroidism.
作者
陈瑞燕
谢晓娜
吴春芳
CHEN Rui-yan;XIE Xiao-na;WU Chun-fang(Second Department of Internal Medicine,Pengpai Memorial Hospital of Haifeng County,Shanwei 516400,Guangdong,CHINA)
出处
《海南医学》
CAS
2020年第11期1383-1386,共4页
Hainan Medical Journal
基金
广东省自然科学基金(编号:8151008901000065)。
关键词
维持性血液透析
血液透析滤过
高磷血症
钙磷代谢
继发性甲状旁腺功能亢进
Maintenance hemodialysis
Hemodialysis filtration
Hyperphosphatemia
Calcium and phosphorus metabolism
Secondary hyperparathyroidism
