透析液钙浓度对维持性血液透析患者的影响

目的研究不同钙浓度透析液对透析患者钙磷代谢、甲状旁腺素（iPTH）及血压的影响。方法36例维持性血液透析患者随机分为3组,分别采用钙浓度1.25、1.5及1.75 mmol/L透析液连续进行5次常规血液透析治疗,于下次行血液透析时,分别于透析前后测定血清Ca＋＋、P-、iPTH水平。比较3组患者血清Ca＋＋、P-、Ca＋＋×P-及iPTH水平差异。结果观察结束时,DCa 1.5与DCa 1.75组,血清Ca×P水平DCa 1.5组无变化、DCa 1.75组升高（P〈0.05）;iPTH水平DCa 1.5组升高（P〈0.05）,DCa 1.75组降低（P〈0.05）。DCa 1.25组血清Ca×P水平明显降低（P〈0.01）,iPTH水平有显著升高（P〈0.01）。结论高钙透析可增加透析患者的钙负荷及转移性钙化的发生,低钙透析可在有限时间内减轻高钙负荷并降低血压,但长期应用低钙透析液应监测iPTH水平。

Affection of Calcium Concentration in Dialysis Fluid for Hemodialysis Maintaining Patient

Objective To study the affection of varied calcium concentration in dialysis fluid for calcium and phosphate metabolism,parathyroid and blood pressure of hemodialysis patient.Methods 36 cases of such patient were divided into 3 groups.The varied calcium concentration fluid of 1.25,1.5 and 1.75 mmol/L was given in hemodialysis for 5 times.The Ca,P,iPTH were detected before further therapy and were compared.Results The Ca×P level was decreased in DCa 1.25 group,no change in 1.5 group and increased in 1.75 group.The iPTH level was decreased with the DCa concentration increasing.Conclusion The high concentration of calcium in dialysis fluid might increase the calcium load and transverse calcium happening.The low calcium concentration might decrease calcium load and decrease blood pressure but monitoring of iPTH level should be taken.