摘要
目的 探讨低钙透析对慢性肾衰竭维持性血液透析患者甲状旁腺功能的影响。方法 前瞻性观察 5 8例维持性血液透析患者在单次高钙透析 (透析液钙 1.75mmol/L)、单次低钙透析 (透析液钙1.2 5mmol/L)前后及持续低钙透析 1个月后 (2～ 3次 /周 ,4小时 /次 )血钙及甲状旁腺激素水平的变化。结果①单次高钙透析 4小时后血钙水平明显升高 [(2 .18± 0 .15 )mmol/Lvs (2 .35± 0 .0 8)mmol/L],iPTH水平没有明显变化 [(191.4 1± 10 8.19)ng/Lvs (190 .4 1± 93.5 0 )ng/L]。②单次低钙透析 4小时后血钙水平没有明显变化 [(2 .2 0± 0 .13)mmol/Lvs (2 .2 2± 0 .17)mmol/L) ],但iPTH显著升高 [(186 .0 5± 10 6 .2 4 )ng/Lvs (2 10 .0 4± 113.4 6 )ng/L) ]。③持续低钙透析 1月后血钙水平没有变化 [(2 .2 0± 0 .13)mmol/Lvs(2 .2 3± 0 .11)mmol/L],iPTH有明显升高 [(186 .0 5± 10 6 .2 4 )ng/Lvs (2 2 9.98± 12 0 .2 0 )ng/L]。结论 低钙透析会刺激甲状旁腺激素的分泌 ,加剧尿毒症患者的继发性甲状旁腺功能亢进。
Objective To investigate the effect of low calcium dialysate on iPTH levels of maintenance hemodialysis patients. Methods Fifty-eight chronic HD patients(male/female 37/21, mean age (47.2±10.4) years, mean HD periods: (3.7±1.2) years who had been dialyzed with 1.75mmol/L Ca ++ dialysate were studied. All patients were transferred to the low calcium(1.25mmol/L) dialysate. The serum level of Ca ++ , Pi and iPTH were measured after a single HD session and after one month low-calcium hemodialysis. Results ① The iPTH had no change after one session of high calcium dialysis despite that serum Ca ++ level increased significantly from [(2.18±0.15)mmol/L to (2.35±0.08)mmol/L];② Although serum Ca ++ did not change, iPTH increased significantly after a single low-calcium dialysis session [(186.05±106.24)ng/L vs (210.04±113.46)ng/L)]; ③After one month of low-Ca ++ hemodialysis, though serum Ca ++ had no change, iPTH increased significantly [(186.05±106.24)ng/L vs (229.98±120.20)ng/L]. Conclusions Low calcium dialysate stimulates the secretion of parathyroid hormone in maintenance hemodialysis patients.
出处
《中国血液净化》
2004年第2期85-86,116,共3页
Chinese Journal of Blood Purification
