摘要
目的观察生理浓度钙透析液对伴低甲状旁腺素水平血液透析患者矿物质及骨代谢的影响。方法将48例血清iPTH(65～150pg/ml)伴校正钙水平≥2.37mmol/L患者按使用透析液钙浓度不同随机分为:透析液钙浓度1.50mmol/L(DCa-1.50)与1.25mmol/L(DCa-1.25)两组;两组内按是否口服骨化三醇随机分为两亚组:口服骨化三醇(+Calcitriol)与非口服骨化三醇(-Calcitriol)组;治疗6个月。每3个月检测透前血清Ca,P,iPTH,ALP及BGP指标。结果观察结束时,DCa-1.5-Calcitriol,DCa-1.25+Calcitriol及DCa-1.25-Calcitriol组血清iPTH及BGP水平升高(P<0.05);DCa-1.25+Calcitriol及DCa-1.25-Calcitriol组血清Ca水平降低(P<0.05),Ca×P水平降低(P<0.05);DCa-1.5+Calcitriol组血清较同期DCa-1.25-Calcitriol组水平Ca水平增高(P<0.05);透前血清iPTH与BGP水平呈正相关(r=0.181,P<0.05)。结论生理浓度钙透析液能够减轻高钙负荷,持续有效刺激甲状旁腺素分泌及改善受抑制的骨代谢。联合骨化三醇及定期监测上述指标,可以安全有效的维持甲状旁腺素在适当水平不引发骨质疏松。
Objective To observe the effects of dialysate with physiological calcium concentration on mineral and bone metabolism in hemodialytic patients with low level of parathyroid hormone.Methods Forty-eight patients with serum predialysis intact PTH concentration,ranged from 65~150 pg/ml,and with calcium concentration over 2.37 mmol/L were randomly divided into DCa-1.25 group（1.25 mmol/L） and DCa-1.50（1.50 mmol/L） group according to calcium concentration in dialysate.Patients in each group were randomly divided into oral Calcitriol group（＋Calcitriol） and non-oral Calcitriol group（-Calcitriol） according to with or without oral use of Calcitriol.All patients were treated for six months.The serum concentrations of calcium,phosphorous,iPTH,ALP,and BGP before dialysis were measured every 3-month.Results The serum concentrations of iPTH and BGP increased in DCa-1.5-Calcitriol group,DCa-1.25＋Calcitriol group,and DCa-1.25-Calcitriol group（P0.05）.The serum concentrations of calcium and Ca×P decreased in DCa1.25＋Calcitriol group and DCa-1.25-Calcitriol group（P0.05）.The serum calcium in DCa-1.5＋Calcitriol group was higher than that in DCa-1.25-Calcitriol group（P0.05）.The serum concentration of iPTH before dialysis positively associated with that of BGP（r=0.181,P0.05）.Conclusion The dialysate with physiological calcium concentration can alleviate the high calcium load,continually stimulate the secretion of parathyroid hormone,and improve the inhibited bone metabolism.The combination of Calcitriol and monitor of above indexes at a regular interval can safely and effectively maintain a proper parathyroid hormone level in order to prevent osteoporosis.
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2012年第1期17-20,39,共5页
Chinese Journal of Osteoporosis
基金
黑龙江省教育厅科学技术研究项目(11531170)
关键词
生理钙浓度透析液
维持性血液透析
低甲状旁腺素水平
矿物质
骨代谢
Dialysate with physiological calcium concentration
Maintenance haemodialysis
Low level parathyroid hormone
Bone metabolism
