低钙透析液联合醋酸钙对血液透析患者高磷血症的影响

目的：研究低钙透析液联合醋酸钙治疗对血液透析患者血磷、血钙及甲状旁腺激素iPTH水平的影响。方法：将30例维持性血液透析患者随机分为试验组和对照组，在试验期间所有患者均低磷饮食，两组透析液钙浓度均为1．25mmol／L，试验组同时给予醋酸钙治疗，对照组不应用醋酸钙治疗，三个月后观察和比较两组患者的血钙、血磷及血iPTH水平的变化。结果：治疗前，两组各组血磷、血钙、血磷和血iPTH的水平比较差异均无统计学意义（P〉0．05）。治疗后，对照组血钙水平明显下降（P〈0．05），血iPTH水平略上升但无统计学意义（P〉0．05），血磷水平无显著变化（P〉0．05）；试验组血iPTH水平略下降（P〉0．05），血钙水平无明显变化（P〉0．05），但血磷明显下降（P〈0．05）；且试验组血磷水平较对照组明显下降（P〈0．05），血钙水平显著高于对照组（P〈O．05），但在正常范围内，两组血iPTH水平比较无统计学意义（P〉0．05）。结论：低钙透析液联合醋酸钙治疗可有效降低血液透析患者的血磷水平，且不会导致高钙血症的发生。

Influence f low Calcium Dialysate Combined with Calcium Acetate on Hyperphosphatemia of Patients with Hemodialysis

Objective： To study the effect of low calcium dialysate combined with calcium acetate on serum phosphorus, calcium and parathyroid hormone iPTH level of patients with hemodialysis. Methods： 30 cases of maintenance hemodialysis patients were randomly divided into the experimental group and control group. During the test, patients were supplemented with low phosphorus diet, and dialysate calcium concentration of the two groups were 1.25 mmol/L. The experimental group was given calcium acetate for the treatment at the same time. The control group did not use it, then the changes in serum calcium, phosphorus and parathyroid hormone level of the two groups patients were observed and compared after three months. Results： Before treatment, no significant difference was found in the serum calcium, phosphorus and parathyroid hormone levels between the two groups（P〉0.05）. The serum calcium level of the control group was decreased significantly （P〈0.05）, the serum iPTH level was slightly increased but had no statistical significance （P〉0. 05）, no chang was found in serum phosphorus level （P〉0.05）. The serum iPTH level of experimental group was slightly decreased （P〉0. 05）, no change was observed in serum calcium level （P〉0.05）, but the serum phosphorus decreased significantly （P〈0.05）; the serum phosphorus level of experimental group was significantly lower than that of the control group （P〈0.05）, the serum calcium level was significantly higher than that of the control group （P〈0.05）, but in the normal range, no statistical difference of serum iPTH level was observed between the two groups （P〉0.05）. Conclusion： Low calcium dialysate combined with calcium acetate could efficiently reduce the serum phosphate level ofhemodialysis patients and hypercalcemia won＇t occur.