血液灌流串联血液透析对钙磷代谢及甲状旁腺素影响的临床观察

目的探讨血液灌流器与透析器串联对钙磷代谢及甲状旁腺素的影响。方法将在我院长期维持性血液透析患者64例，随机分为两组。联合组为血液灌流串联血液透析，共33例。对照组为单纯血液透析，共31例。6个月后检测血甲状旁腺素、血钙及血磷，并观察皮肤瘙痒的改善情况。结果联合组血磷、甲状旁腺素均明显下降，血钙明显上升，差异有统计学意义（P〈0．05）。对照组血磷、甲状旁腺素均明显下降，差异有统计学意义（P〈0．05）。联合组治疗后血甲状旁腺素、血磷均较对照组治疗后下降明显，差异有统计学意义（P〈0．05）。联合组皮肤瘙痒较对照组明显减轻。结论血液灌流串联血液透析能有效调节钙磷代谢，降低甲状旁腺素水平，改善皮肤瘙痒症状，提高患者生活质量。

Clinical observation of hemoperfusion combined with hemodialysis in regulating calcium phosphorus metabolism and parathyroid hormone

Objective To study the effect of hemoperfusion combined with hemodialysis in regulating calcium phosphorus metabolism and parathyroid hormone. Methods Sixty-four patients with uremia were randomly divided into two groups：series groups（n = 33） were given hemoperfusion combined with hemodialysis. The control groups（n = 31 ） were treated with hemodialysis exclusively. The total observation period was six month. During the treatment, serum calcium, phosphorus and parathyroid hormone concentrations were measured. Results In series groups, serum phosphorus, and parathyroid hormone concentrations were decreased apparently, and serum calcium concentrations increased dramatically, showing significant difference in comparing with pretreatment （P（ 0. I）5 ）. In control groups, serum phosphorus, and parathyroid hormone concentrations were decreased apparently, also show significant difference （P%0. 05）. After treatment for 6 months,serum phosphorus,and parathyroid hormone levels were decreased apparently in series groups as compared with control groups （P〈0.05）. The skin itches in series groups were alleviated remarkably as compared with control groups. Conclusions Hemoperfusion combined with hemodialysis can effectively regulate calcium phosphorus metabolism, decrease parathyroid hormone and alleviate the skin pruritus, so can improve quality of life of patients with uremia.