维持血液透析患者血清钙、磷、甲状旁腺激素水平及高通量滤器干预观察

目的 改善慢性肾衰竭尿毒症维持血液透析患者钙、磷、甲状旁腺代谢紊乱.方法 对解放军第451医院原有82例患者改用高通量滤器透析治疗3个月后,对照钙、磷、甲状旁腺素（iPTH）水平.所有患者B超检测甲状旁腺,并进一步分为增生、非增生2组对比此效果.结果 高通量滤器透析患者血钙升高（t=-4.786,P＜0.05）,血磷、甲状旁腺素水平降低（t=2.341,P＜0.05,iPTH=2.937,P＜0.05）,甲状旁腺增生组效果更为明显（Ca∶ t=-3.583/-3.207,P=0.001/0.003;P：t=1.74/1.619,P=0.089/0.113,iPTH∶ t=2.408/1.830,P=0.001/0.074）. 结论 高通量滤器透析改善了尿毒症维持血液透析患者钙、磷、甲状旁腺代谢紊乱.

Intervention therapy using high flux hemodialyzer on serum calcium,phosphorus, and intact parathyroid hormone in maintenance hemodialysis patients

Objective To improve the abnormal changes of calcium and phosphorus and intact parathyroid hormone （iPTH） in maintenance hemodialysis （MHD） patients using high flux hemodialyzer.Methods In a total of 82 MHD patients the hemodialyzer for hemodialysis was changed from low flux hemodialyzer to high flux hemodialyzer for 3 months.Serum calcium,phosphorus and iPTH were compared before and after using high flux hemodialyzer.Patients were further divided into parathyroid hyperplasia group and normal parathyroid group based on the findings from Doppler ultrasonography.Serum calcium,phosphorus and iPTH were further compared between the two groups.Results After using high flux hemodialyzer,serum calcium levels increased （t =-4.786,P＜0.05）,and phosphorus and iPTH decreased （t =2.341,P＜0.05 for phosphorus; t=2.937,P＜0.05 for iPTH）.These effects were more prominent in parathyroid hyperplasia group than in normal parathyroid group （t =-3.583/-3.207 P=0.001/0.003 for serum Ca; t =1.74/ 1.619,P =0.089/0.113 for serum P; t =2.408/1.830,P=0.001/0.074 for serum iPTH）.Conclusion High flux hemodialyzer was better than low flux hemodialyzer to improve serum calcium and phosphorus and iPTH changes in MHD patients.