高通量低钙透析治疗尿毒症对患者血磷、血钙、iPTH水平的影响

【目的】观察高通量低钙透析对尿毒症的治疗效果及对血磷、血钙和全段甲状腺旁腺素(iPTH)的影响。【方法】选取2016年8月至2017年8月在本院接受治疗的尿毒症患者为研究对象,根据其透析方式分为高通量透析组(对照组)和高通量低钙透析组(观察组)。观察两组患者透析前后病人营养评价表(SGA)评分、血磷、血钙和iPTH水平,比较两组患者治疗前后血生化指标、炎症细胞因子水平的差异。【结果】两组患者治疗前SGA评分、血磷、血钙和iPTH水平无差别,治疗后,观察组患者的SGA评分高于对照组,血磷、血钙和iPTH水平低于对照组;两组患者治疗前血尿素氮(BUN)、血肌酐(SCr)和肾小球滤过率(GFR)水平无差别,治疗后,观察组患者的BUN、SCr水平低于对照组,GFR水平高于对照组;两组患者治疗前细胞因子水平无差别,治疗后,观察组患者的白细胞介素-18(IL-18)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)水平低于对照组。【结论】高通量低钙透析对尿毒症的治疗效果较好,可明显改善患者的钙磷和iPTH水平以及肾功能,具有良好的应用价值。

Effects of high-throughput Low-calcium Dialysis on Blood Phosphorus,Calcium and iPTH Levels in Patients with Uremia

【Objective】To observe the effect of high-throughput low-calcium dialysis on uremia treatment and on blood phosphorus,blood calcium and iPTH.【Methods】The patientvS with uremia who were treated in our hospital from August 2016 to August 2017 were selected as the research subjects.According to the dialysis methods,the patients were divided into high-throughput dialysis group and high-throughput low-calcium dialysis group.The levels of patients nutrition evaluation score(SGA),blood phosphorus,blood calcium and iPTH were observed before and after dialysis.The blood biochemical indexes and the levels of inflammatory cytokines in the two groups were compared before and after the treatment.【Results】There were no differences in the score of SGA and levels blood phosphorus,blood calcium and iPTH between the two groups before treatment.After treatment,the SGA score of the patients in the observation group was higher than that of the control group,while the levels of blood phosphorus,blood calcium and iPTH were lower than those of the control group.The levels of BUN,SCr and GFR were not significant differences between the two groups before treatment.After treatment,the levels of BUN and SCr in the observation group were lower than those of the control group,while the level of GFR was higher than that of the control group.There was no difference in cytokine levels between the two groups before treatment.After treatment,the levels of IL-18,IL-6 and hs-CRP in the observation group were lower than those in the control group.【Conclusion】High-throughput low-calcium dialysis has a better therapeutic effect on uremia.It can obviously lower the levels of calcium,phosphorus,iPTH and improve renal function.