中国血液净化

›› 2006, Vol. 5 ›› Issue (7): 351-354.

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调整透析液钙浓度对血液透析患者血钙和甲状旁腺激素的影响

郑丹侠 朱 宁 杨文领 王 松 张爱华 史均宝 庄 震   

  1. 100083 北京，北京大学第三医院肾脏内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2006-07-12 发布日期:2006-07-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2006-07-12 Published:2006-07-12

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摘要： 目的 了解调整透析液钙浓度对血液透析患者血钙和甲状旁腺激素(PTH)的影响。方法 选择北京大学第三医院肾脏内科23例血液透析患者，血PTH＞300pg/ml，调整其透析液钙浓度，以观察其血钙和PTH变化。结果 按入选时的血钙水平将这些患者分成低血钙组和正常血钙组。将透析液钙浓度从1.25 mmol/L提高到1.5mmol/L后一个月，低血钙组患者的血钙水平显著升高[从(1.92±0.15)到(2.06±0.12)mmol/L，P ＜0.001)]，同时血PTH水平明显下降[从(615±305)到(306±180)pg/ml，P ＜0.001)，而正常血钙组患者的血钙和PTH水平变化不大。结论 如果同时有低血钙和高PTH血症，提高透析液钙浓度可以使这些血液透析患者的血钙正常并使其血PTH水平下降。

关键词: 甲状旁腺激素, 血钙, 血液透析, 透析液

Abstract: Objective To observe the influences upon serum calcium and parathyroid hormone (PTH) by adjusting the dialysate calcium concentration in hemodialysis (HD) patients. Methods Serum calcium and intact PTH levels in twenty-three HD patients were observed when their dialysate calcium concentration was adjusted. These patients were divided into two groups by their initial serum calcium levels: hypocalcaemia group and normal calcaemia group.Results One month after increasing the dialysate calcium concentration from 1.25 to 1.5mmol/L, the serum calcium was increased [from (1.92±0.15) to (2.06±0.12)mmol/L，P＜0.001) and serum iPTH level was decreased [from (615±305) to (306±180) pg/ml，P＜0.001) in the hypocalcaemia group; The serum calcium and serum iPTH level were not significantly changed in the normal calcemia group. Conclusion Increasing dialysate calcium concentration is helpful to the HD patients who have both hypocalcemia and high serum PTH levels.

Key words: Serum calcium, Hemodialysis, Dialysate

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