中国血液净化

›› 2005, Vol. 4 ›› Issue (4): 185-186.

• 论著 • 上一篇    下一篇

慢性肾衰竭患者钙磷代谢紊乱相关临床意义

龚 蓉 王 平 刘蔓莉 陈 颖   

  1. 610031 成都，四川省成都市三人民医院肾内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2005-04-12 发布日期:2005-04-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2005-04-12 Published:2005-04-12

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摘要：

目的 探讨慢性肾衰竭血液透析患者钙磷代谢紊乱相关临床意义及防治。方法 分析62例慢 性肾衰竭稳定血液透析患者，统计其透析前血清钙、磷，甲状旁腺素（iPTH）C-反应旦白（CRP），血肌酐(Scr)，透析后血磷。计算钙磷乘积≤5500（mg/L）2为A组，＞5500（mg/L）2为B组，计算两组病死率、皮下软组织钙化率，进行统计学分析。 结果 2组Scr，年龄、CRP差异无显著性（P＞0.05），两组病死率，皮下软组织钙化，血磷，透析时间差异有显著性(P<0.05)，钙磷乘积与血磷浓度、病死率，皮下软组织钙化、透析时间呈正相关(P<0.05)，与 Scr，年龄，血钙，CRP，iPTH无明显相关。所有患者血液透析前血磷水平为(2.10±0.41)mmol/L。结论 血液透析患者多存在钙磷代谢紊乱，尤以钙磷乘积，血磷升高尤为突出，并随透析时间延长而加重，而钙磷乘积升高与病死率，皮下软组织钙化率密切相关，个体化治疗是改善钙磷代谢紊乱的基本方法。

关键词: 肾衰竭, 血液透析 钙磷代谢

Abstract:

To investigate the chinical significance and the prevention and treatment of disorders of calcium and phosphorus metabolism in chronic hemodialysis patients. Methods The study was performed in 62 chronic hemodialysis patients. Their serum calcium, phosphorus, intact parathyroid hormone (iPTH), C-reactive protein (CRP), serum creatinine (Scr) were measured before and phosphorus was measured after one dialysis session.Calcium phosphorus product were calculated. The patients with the product ≤5500（mg/L）2 divided into the A group, and the product >5500（mg/L）2 in B gorup. Death rates were calculated and soft tisue calcification were observed. Results There were significant difference between the two groups of death rate, soft tissue calcification, blood phosphorus and dialysis time (P>0.05). Positive correlation were found between calcium-phosphorus product and serum phosphous, death rate soft tissue calcification and dialysis time (P<0.05). The mean serum phosphorus level before dialysis of all patients was (2.1±0.41)mmol/L. Conclusions Disorders of calcium and phosphorus metabolism, especially high calcium phosphorus product, hyperphosphatemia are common on hemodialysis patients. There disorders become move critical following the hermodialysis process. The increasing of calcium phosphorus product has close relation with the death rate and soft tissue calcification. Individual therapy are suggested to improve the disorders of calcium and phosphorus metabolism.

Key words: Hemodialysis, Calcium phosphorus metabolism 

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