中国血液净化

中国血液净化 ›› 2017, Vol. 16 ›› Issue (04): 217-219.doi: 10.3969/j.issn.1671-4091.2017.04.001

• 专题 •    下一篇

透析患者动脉中层钙化和钙化防御的危险因素、治疗和预后

贺忆培1,倪兆慧1   

  1. 1. 上海交通大学医学院附属仁济医院肾脏科
  • 收稿日期:2016-09-29 修回日期:2016-11-30 出版日期:2017-04-12 发布日期:2017-04-12
  • 通讯作者: 倪兆慧 profnizh@126.com E-mail:profnizh@126.com

Risk factors, treatment and prognosis of arterial medial calcification and calciphylaxis in dialysis patients

  • Received:2016-09-29 Revised:2016-11-30 Online:2017-04-12 Published:2017-04-12

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摘要： 钙化防御(calciphylaxis)，又称钙性尿毒症性小动脉病(calcific uremic arteriolopathy,CUA)是一种罕见但具破坏性的临床综合征，主要见于慢性肾衰竭行透析治疗的患者，具有高死亡率。慢性肾脏病-矿物质与骨异常、人口统计学因素(如女性、白人等)、某些合并症及药物可增加CUA罹患风险。目前常用疗法包括进行伤口、疼痛、营养等方面的管理，延缓危险因素，调整透析方式及处方，及静脉注射硫代硫酸钠等。CUA患者的预后较差，局部及全身感染与低生存率相关，积极抗感染治疗不影响死亡率。

关键词: 钙化防御, 透析, 危险因素, 治疗, 预后

Abstract: Calciphylaxis, also known as calcific uremic arteriopathy (CUA), is a rare but devastating clinical syndrome with high mortality, mainly seen in chronic renal failure patients treated with dialysis. Chronic kidney disease - mineral and bone disorder (CKD-MBD), demographic factors (such as women, white people,etc.), and some complications and drugs can increase the risk of CUA. Currently, the commonly used therapies include management of wound, pain and nutrition, avoiding risk factors, modulating dialysis modality and prescription, and intravenous sodium thiosulfate (STS). CUA patients have poor prognosis. Local and systemic infections are related to the low survival rate, and active anti-infection therapy does not affect the mortality.

Key words: Calciphylaxis, Dialysis, Risk factor, Treatment, Prognosis