低钙透析液联合鲑鱼降钙素治疗血透患者高磷血症的临床研究

目的 观察低钙透析液联合鲑鱼降钙素对血透患者高磷血症的影响.方法 选取近期维持性血液透析患者中高磷血症患者40例,随机分为对照组和实验组各20例,对照组用正常钙透析液(钙离子浓度为1.5 mmol)配合碳酸钙和活性维生素D3治疗.实验组用低钙透析液(钙离子浓度为1.25 mmol)联合鲑鱼降钙素注射液同时服用碳酸钙和活性维生素D3治疗.观察治疗后第1、3、6个月时患者的血钙、血磷、钙磷乘积以及全段甲状旁腺激的水平.结果 对照组透析后,与透析1个月比较,6个月血钙、血磷、钙磷乘积均轻度增高(P＜0.05),而iPTH水平无明显变化(P＞0.05)；实验组透析后,与透析1个月比较,3个月血钙、血磷、钙磷乘积均轻度减低(P＜0.05),而iPTH水平明显增高(P＜0.05)；6个月血钙、血磷、钙磷乘积均轻度减低(P＜0.05),而iPTH水平趋于稳定(P＞0.05)；与对照组比较,实验组患者3个月血磷、钙磷乘积均轻度减低(P＜0.05),而iPTH水平明显增高(P＜0.05)；实验组患者6个月血磷、钙磷乘积、iPTH均轻度减低(P＜0.05).结论 低钙透析液联合鲑鱼降钙素治疗HD患者能有效的维持血磷水平,降低钙磷乘积,而不致影响iPTH.

Clinical study of low calcium dialysate combined with salmon calcitonin in the treatment of hyperphosphatemia in hemodialysis patients

Objective To observe the effect of low calcium dialysate combined with salmon calcitonin in the treatment of hyperphosphatemia in hemodialysis patients. Methods Forty hemodialysis patients with hyperphosphatemia were randomly divided into the study group and the control group, each with 20 cases. Patients in the control group were treated with low calcium dialysate (with Ca2+ concentration of 1.5 mmol) combined with calcium carbonate as well as vitamin D3, while those in the study group were treated with low calcium dialysate (with Ca2+ concentration of 1.25 mmol) combined with salmon calcitonin, as well as calcium carbonate and vitamin D3. The Ca, P, calcium-phosphate product, iPTH were detected one, three, and six months after treatment.Results Compared with one month after treatment, the levels of Ca, P calcium-phosphate product in the control group six months after treatment were slightly increased (P<0.05), while iPTH showed no statistically significant difference (P>0.05). Compared with one month after treatment, the levels of Ca, P and calcium-phosphate product in the study group were slightly decreased 6 months after treatment (P<0.05), while iPTH showed no statistically significant difference (P>0.05), Compared with the control group, the levels of P and calcium-phosphate product in the study group were decreased with iPTH increased in the study group 3 months after treatment (P<0.05), while P, calcium-phosphate product and iPTH 6 months after treatment were decreased (P<0.05). Conclusion For hemodialysis patients with hyperphosphatemia, low calcium dialysate combined with salmon calcitonin can effectively maintain serum phosphate levels, reduce calcium-phosphate product, with no effect on iPTH.