醋酸钙与碳酸钙治疗血液透析患者高磷血症的疗效比较

目的：比较醋酸钙与碳酸钙治疗血液透析患者高磷血症的治疗效果.方法：以碳酸钙作为对照,以血磷、血钙、血浆全段甲状旁腺激素（iPTH）和不良反应发生率为观察指标,比较醋酸钙和碳酸钙的疗效和安全性.结果：0-8周两组血磷水平均下降,第2周醋酸钙和碳酸钙组血磷水平分别为（1.91＆#177;0.78）mmol/L和（2.14＆#177;0.57）mmol/L,差异有显著性（P＜0.05）;0-8周两组血钙水平均上升,第8周醋酸钙和碳酸钙组血钙水平分别为（2.41＆#177;0.31）mmol/L和（2.72＆#177;0.21）mmol/L,差异有显著性（P＜0.05）;0-8周iPTH两组比较无差异;不良反应发生率醋酸钙组为20％,碳酸钙组为23％,发生率比较无显著性差异.结论：醋酸钙降低血磷的效果与碳酸钙相同,但其起效时间较碳酸钙短;醋酸钙同样可导致血钙的升高,但血钙升高的幅度较碳酸钙小,也较少发生高钙血症,胃肠道反应是其主要的副作用,综合考虑,醋酸钙较碳酸钙在治疗高磷血症上有更多的优势.

Comparison of the Efficacy of Treatment of Hyperphosphatemia with Calcium Carbonate and Calcium Acetate Hemodialysis

Objective： Comparison of calcium acetate and calcium carbonate therapy treatment in hemodialysis patients hyperphosphatemia. Method Calcium carbonate as a control, phosphorus, calcium, serum PTH and adverse reactions was observed indicators to compare calcium acetate and Calcium carbonate the effectiveness and safety. Results 0-8 week two phosphorus levels were decreased, the second week calcium acetate and calcium carbonate＇s phosphate level are （1.91 ± 0.78）mmol/L and （2.14 ± 0.57）mmol/L, it has significantly difference（P〈0.05）; 0-8 weeks both groups calcium levels were increased, the eighth week calcium acetate and calcium carbonate＇s calcium level are （2.41 ± 0.31）mmol/L and （2.72 ± 0.21）mmol/L,it has significant difference（P〈0.05）; 0-8 weeks has no difference in serum PTH groups; adverse reaction rates of calcium acetate is 20%, calcium carbonate is 23%, no significant difference in the incidence. Conclusion Reduce the effect of calcium acetate and calcium phosphate were same, but its onset time shorter than the calcium carbonate; calcium acetate may also lead to elevated blood calcium, but the magnitude of elevated serum calcium acetate was smaller and less high incidence hypercalcemia, gastrointestinal reactions are the main side effects into account, compared to calcium carbonate, calcium acetate in the treatment of hyperphosphatemia has more advantages.