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不同钙浓度枸橼酸透析液对血钙和甲状旁腺激素水平的影响 被引量：7

Different calcium concentration Citrate dialysate consequences on calcium and PTH in hemodialysis patients
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摘要 目的比较不同钙浓度枸橼酸盐透析液对维持性血液透析患者血钙和甲状旁腺激素（PTH）水平的影响。对比分析二代PTH（全段，intactPTH）和三代laTH（活性全段，biointactPTH1．84）检测与血钙和PTH的相关度。方法15例长期维持性血液透析（MHD）患者每周接受不同钙浓度的枸橼酸透析液治疗，透析液钙浓度分别为1．75mmol／L（DCa1．75）、1．5mmol／L（DCa1．5）和1．25mmol／L（DCa1．25）。采用自身前后对照研究方法，比较不同钙浓度枸橼酸透析液对患者透析前、后血清总钙（tCa）、离子钙（iCa）、全段PTH（iPTH）、活性全段PTH（bio．iPTH）水平的影响。结果（1）与透析前相比，DCa1．75组患者透析后tCa、iCa水平升高（P〈0．05），PTH有下降趋势；DCa1．5组透析后tCa、iCa水平差异无统计学意义，但PTH较透析前升高；DCa1．25组透析后tCa、iCa均低于透析前（P〈0．05），PTH较透析前升高。（2）两种PTH检测结果提示，iPTH绝对数明显高于bio．iPTH，两者有良好的相关性（R=0．98）。与iPTH相比，bio．iPTH变化与血钙浓度变化有更好的相关度。结论DCa1．75、DCa1．5mmol／L枸橼酸透析液单次透析后能更好地维持血透患者的血钙稳定，对胛H影响相对较小。检测bio．iPTH较iPTH能更好地反映由钙浓度变化导致的体内活性PTH改变。 Objective To evaluate the effects on the mineral bone disorder using different calcium eoneentration citrate-based dialysate in maintenance hemodialysis （MHD） patients. To compare the concentrations of intact parathyroid hormone（PTH） with biointact PTH（1- 84） in these patients. Methods Citrate dialysate with different calcium concentration （DCa 1.75, DCa 1.5, DCa 1.25 mmol/L） were used in turn in 15 stable MHD patients each week. Serum tCa and iCa were measured by automatie biochemistry analyzer. The concentrations of iPTH and bio-iPTH were compared. Results （1） The patients treated with DCa 1.75 citrate dialysate had increased serum iCa and tCa after dialysis, and PTH did not change significantly as compared to those findings before the dialysis. With the DCa 1.5 eitrate dialysate, serum iCa and tCa were kept stable and PTH level was increased. With DCa 1.25 eitrate dialysate, serum iCa and tCa decreased signifieantly and PTH decreased. （2）iPTH and bioPTH had excellent correlations. Variation of bio-iPTH was more correlated with the changes of calcium than iPTH. Conclusions Serum levels of iPTH, tCa and iCa can be kept stable in MHD patients treatedwith DCa 1.75 ~ 1.5 citrate dialysate. Bio-iPTH is a more sensitive marker for mineral bone disease than iPTH.
作者 丁嘉祥 郭王 韩雪 张金凤 刘文虎
机构地区 首都医科大学附属北京友谊医院肾内科首都医科大学肾病学系 北京右安门医院肾内科透析室
出处 《中华肾脏病杂志》 CAS CSCD 北大核心 2015年第2期109-114,共6页 Chinese Journal of Nephrology
基金 基金项目：十二五科技支撑计划（2011BA110800） 北京市科技基金（D131100004713001）
关键词 透析液 钙 血清 甲状旁腺激素 血液透析 Dialysate Calcium, serum Parathyroid hormone Hemodialysis
分类号 R692.5 [医药卫生—泌尿科学]
  • 相关文献

参考文献16

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共引文献12

同被引文献70

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二级引证文献17

中华肾脏病杂志
2015年 第2期

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