中国血液净化

中国血液净化 ›› 2014, Vol. 13 ›› Issue (03): 140-142.doi: 10.3969/j.issn.1671-4091.2014.03.004

• 临床研究 • 上一篇    下一篇

透析中心夜间血液透析对尿毒症患者血磷代谢的影响

袁艳辉,戎殳,张翼翔,陈静,张斌,计雁飞,叶朝阳,梅长林   

  1. 第二军医大学长征医院肾内科
  • 收稿日期:2013-08-12 修回日期:2013-09-11 出版日期:2014-03-12 发布日期:2014-03-12
  • 通讯作者: 戎殳 jingweisy@126.com E-mail:jingweisy@126.COM
  • 基金资助:

    国家然科学基金资助项目（编号 81200542）上海市重点学科建设项目（编号 B902）

In-center nocturnal hemodialysis on phosphorus metabolism in uremic patients

  • Received:2013-08-12 Revised:2013-09-11 Online:2014-03-12 Published:2014-03-12

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摘要： 【摘要】 目的 观察透析中心夜间长时血液透析（INHD）模式对尿毒症患者高磷血症的疗效。 方法 调查INHD时间6个月以上的56例患者进入INHD前1~3个月及进入INHD至2013年5月透析情况、透析前血磷、血钙、血iPTH检测值，分析血磷变化趋势，统计患者降磷药物服用情况。 结果 患者进入INHD前3个月内平均血磷水平变化无统计学差异，进入INHD后1个月平均血磷水平即显著下降（p<0.05），之后持续稳定在<1.67mmol/L水平；进入INHD后，有15例患者的31次（6.5%）检测出现低磷血症，发生过低磷血症的患者年龄更大、体重指数（BMI）更低、接受NHD时间更长（p<0.05）；进入INHD后有14例（25%）患者停用降磷药物。 结论 INHD能持续、平稳、有效地控制透析患者高磷血症，低磷血症发生率较低。

关键词: 夜间血液透析, 尿毒症, 高磷血症, 低磷血症

Abstract: Objective To observe the effect of in-center nocturnal hemodialysis (INHD) on hyperphosphatemia in uremic patients. Methods fifty-six patients who received INHD more than 6 months were investigated. The predialysis serum phosphorus, serum calcium and serum iPTH before and after entering INHD were collected. And the uses of phosphate binders were recorded. Results Within the 3 months before entering INHD, there was no significant difference in average serum phosphate levels. The average phosphorus levels significantly decreased (p<0.05) from 1 month after entering INHD and was steady at <1.67 mmol/L. Hypophosphatemia were detected in 31 cases (6.5%) of 15 patients. It occurred in patients with older age, less body mass index (BMI) and longer NHD duration (p<0.05). After entering INHD, withdrawal of phosphate binders were observed in 14 patients (25%). Conclusion INHD can effectively and stably control hyperphosphatemia in dialysis patients,whit the lower prevalence of  hypophosphatemia .

Key words: nocturnal hemodialysis, Uremia, hyperphosphatemia, hypophosphatemia