2种不同磷结合剂治疗维持性血液透析患者高磷血症的对比研究

目的观察对比2种不同的磷结合剂对维持性血液透析患者高磷血症的治疗效果。方法选取肾内科维持性血液透析并高磷血症患者64例,随机分为观察组和对照组各32例,对照组应用碳酸钙治疗,观察组应用盐酸司维拉姆进行治疗。观察两组患者的治疗有效率及血液生化指标中血清高密度脂蛋白、血磷、血清钙磷乘积的变化情况及不良反应。结果治疗后,观察组和对照组患者血磷、血清钙磷的乘积均较治疗前显著下降,差异具有统计学意义（P〈0.05）;观察组这两项指标下降更为明显,与对照组相比差异具有统计学意义（P〈0.05）;观察组的治疗有效率显著高于对照组（P〈0.05）;观察组患者血清高密度脂蛋白较治疗前显著上升（P〈0.05）;观察组高钙血症发生率低于对照组,但差异无统计学意义（P〉0.05）。结论盐酸司维拉姆比碳酸钙对维持性血液透析患者高磷血症具有更好的短期疗效。

The comparative analysis of 2 kinds of phosphate binder in the treatment of maintenance hemodialysis patients with hyperphosphatemia

Objective To observe and campare the clinical effect of 2 kinds of phosphate binder in the treatment of maintenance hemodialysis patients with hyperphosphatemia.Methods 64 maintenance hemodialysis patients with hyperphosphatemia were collected and randomly divided into two groups, 32 cases of each group . patients in the control group received calcium carbonate for hyperphosphatemia treatment, and the patients in observation group received Hydrochloride Division Wei Lamu hyperphosphataemia treatment. Then to observe changes of the treatment efficiency, blood biochemical parameters in serum high-density lipoprotein, phosphorus, serum calcium phosphorus product and adverse reactions.Results After treatment, patients’ phosphorus, serum calcium and phosphorus product were significantly decreased than before treatment（P〈0.05）, and these two indicators of the observation group were significantly decreased more than those of the conctrol group（P〈0.05）; observation group treatment efficiency were significantly higher（P〈0.05）; blood biochemical parameters in serum high-density lipoprotein of the observation group was significant higher than that of the conctrol group（P〈0.05）;The incidence of hypercalcemia in the observation group was less than that in the control group, but the difference had no statistically significant（P〉0.05）. Conclusion Sevelamer hydrochloride in maintenance hemodialysis patients with hyperphosphatemia has better short-term results than calcium carbonate.