中国血液净化

›› 2008, Vol. 7 ›› Issue (6): 311-313.

• 论著 • 上一篇    下一篇

低钙透析液对维持性腹膜透析患者心脏结构及功能的影响

刘智辉 包瑾芳 刘 军 郝 静 唐知还 袁伟杰   

  1. 200080 上海交通大学附属第一人民医院肾内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2008-06-12 发布日期:2008-06-12

The study of the effect of low calcium dialysate on cadiac function in CAPD patients

BAO Jin-fang,LIU Jun,HAO jing,TANG Zhi-huan,YUAN Wei-jie   

  1. Department of Neprhrology The First People's hospital,shanghai jiaotong University, shanghai 200080, China
  • Received:1900-01-01 Revised:1900-01-01 Online:2008-06-12 Published:2008-06-12

RichHTML

0

PDF

378

摘要： 【摘要】目的 观察低钙透析液对CAPD患者心脏形态及功能的影响。 方法 选择2007年1月～6月在上海第一人民医院腹膜透析门诊规律随访的CAPD患者31例，所有患者均使用标准钙(PD2)透析液，透析过程平稳。入组后换用百特PD4透析液治疗，其余治疗方案不变。在改用透析液前与改用后6月行血生化、心电图和超声心动图检查。同时选取健康对照组15例行超声心动图检查。结果 患者改用PD4后血钙水平和钙磷乘积显著低于改用前，血PTH水平较换用前显著升高 (P＜0.05)，其余生化指标无显著性差异。使用PD4前后心电图中的QTd、QTcd的变化无显著性。改用PD4后的IRT水平显著低于改用前，E/Amax水平显著高于改用前(P＜0.05)。相关性分析发现血钙变化与IRT变化呈正相关（r＝0.36，P＜0.05），与E/Amax的变化呈负相关（r＝-0.27,P＜0.05），血钙磷乘积的变化与IRT变化呈正相关（r＝0.29，P＜0.05），与E/Amax的变化呈负相关（r＝-0.22,P＜0.05），PTH的变化与IRT、E/Amax的变化无相关性（P＞0.05）。结论 低钙透析液对患者心脏结构无明显影响，但有调节患者异常钙、磷代谢的作用，同时可改善患者的左室舒张功能，此作用可能与纠正钙磷代谢紊乱有关。

关键词: 慢性肾功能不全, 腹膜透析, 低钙透析液, 超声心动图

Abstract: Objective To investigate the effect of low calcium dialysate on cadiac function in CAPD patients. Methods Thirty-one CAPD patients were selected in this study.Standard calcium dialysate solution was changed to lower calcium dialysate solution.The cardiac function were echocardiographically examined at the beginning and the end of this study,respectively.The serum biochemical indicators and standed 12-lead electrocardiogram were examined at the beginning and the end of this study,respectively. 15 age- and sex-matched controls were also observed. Rusults After changing to PD4,secrum calcium concentration decreased, and PTH increased significantly.The changes in QTd、QTcd were not statistically significant.The changes in E/Amax、IRT were statistically significant.The change in serum calcium has negtive relation with the change in E/Amax and positive relation with the change in IRT. Conclusion There were favorable changes in left ventricular diastolic function after treatment with low calcium dialysate.The changes may be associated with the ameliorate of calcium phosphate metabolism and calcium overload.

中图分类号: