摘要
目的观察血液透析中高磷血症患者应用碳酸司维拉姆联合低钙透析治疗的疗效。方法选取安徽省第二人民医院肾内科长期使用1.5 mmol/L浓度钙透析液的,同时伴有血磷水平升高的49例维持性血液透析患者,观察其改用1.25 mmol/L浓度钙透析液及口服碳酸司维拉姆治疗3个月、6个月后血钙、血磷及血i PTH等指标水平的变化。结果治疗前血磷为(2.18±0.29)mmol/L,3个月、6个月分别为(1.79±0.25)mmol/L、(1.58±0.22)mmol/L,血磷水平较治疗前明显下降,差异均有统计学意义,治疗后血钙磷乘积、i PTH与hs-CRP较治疗前明显下降,差异有统计学意义(均P<0.001),治疗6个月后血清钙较治疗前下降,有统计学差异(P<0.05),治疗过程中出现胃肠道不良反应5例,反复低血压2例,经处理后均缓解。结论碳酸司维拉姆联合低钙透析液能有效地纠正高磷血症,控制钙磷乘积及i PTH,降低炎症指标hs-CRP,同时安全性较高,值得在临床治疗中推广应用。
Objective To observe the effect of low calcium dialysate combined with Sevelamer carbonate on the patients with hyperphosphatemia in maintenance hemodialysis （MHD）. Methods 49 patients those who accepted MHD treatment in Nephrology Department of Second People＇s Hospital of Anhui Province by using 1. 5mmol/L calcium dialysate and accompanied by elevated serum phosphorus levels were enrolled in this study. The changes of serum calcium, serum phosphorus and blood iPTH were observed 3 months and 6 months after treatment with 1.25 mmol/L calcium dialysate and Sevelamer carbonate.Results The level of serum phosphate was 2.18±0.29mmol/L before the treatment. 3 and 6 months after the treatment, serum phosphorus were 1.79±0. 25mmol/L and 1.58±0.22mmol/L, serum phosphorus levels were significantly decreased, the differences were statistically significant （P〈0.001）. The serum calcium-phosphorus products, blood iPTH and hs-CRP decreased significantly compared with those before treatment, the difference was statistically significant （allP〈0.05）. After treatment for 6 months, serum calcium decreased significantly （P〈 0.05 ）.There were 5 cases of gastrointestinal adverse reactions in the treatment, 2 cases of repeated hypotension, but relief after treatment.Conclusions The combination of Sevelamer carbonate and low calcium dialysis solution can effectively correct hyperphosphatemia, control calcium-phosphorus products and blood iPTH level, reduce inflammation index hs-CRP, obtained high safety, worthy of clinical promotion and application.
作者
章超群
张洪旭
ZHANG Chao-qun(Department of Nephrology, the second people＇s hospital of Anhui, Hefei, Anhui, 230000, China)
出处
《齐齐哈尔医学院学报》
2017年第23期2772-2774,共3页
Journal of Qiqihar Medical University
关键词
司维拉姆
低钙透析
血液透析
高磷血症
Sevelamer carbonate
Low calcium dialysate
Hemodialysis
Hyperphosphatemia
