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1、血液透析患者應(yīng)用低鈣透析液的臨床研究［摘耍］冃的：探討維持性血液透析患者如何應(yīng)用低鈣透析液。方法：將43例試驗前長期應(yīng)用1.25mniol/L低鈣透析液的維持性血液透析患者隨機分入試驗纟R(T組)(20例)和對照組(C組)(23例)。根據(jù)入組時血全段甲狀旁腺激素(intactparathyroidhormone,iPTH)水平<500ng/L或>500ng/L,T組和C組又分別分為T1組(9例)、T2組(11例)和C1組(15例)、C2組(8例)。入組后T組改用1.50mmol/L鈣濃度血液透析液，C組繼續(xù)應(yīng)用1.25mmol/L鈣濃度血液透析液。分別在入紐時和入紐6個月后檢測T紐和C組透析前
2、血iPTH水平、血鈣及血磷水平,計算鈣磷乘積,并進行入組前后和組間的比較。結(jié)果：T1組的血iPTH水平冇下降的趨勢，但與入組前比較差異無統(tǒng)計學(xué)意義(P>0.05)；T1組的血鈣、血磷及鈣磷乘積水平與入組前比較變化均不明顯(P>0.05)oT2組的血iPTH水平顯著下降(PV0.01),血磷水平也冇明顯下降(P<0.05)；而T2組的血鈣和鈣磷乘積水平無變化(P>0.05)oCl組和C2組的血iPTH水平、血鈣、血磷及鈣磷乘積水平與入組前比較差異均無統(tǒng)計學(xué)意義(P>0.05)e結(jié)論：對于伴中重度繼發(fā)性甲旁亢(1PTH水平N500ng/L)、1(11鈣正常或偏低的血液透析患者，長期應(yīng)用1.25mm
3、ol/L濃度透析液可能加重甲狀旁腺功能亢進。這類患者選擇1.50mmol/L鈣濃度的血液透析液有利于降低血iPTH水平，還可降低血磷水平，而不會升高血鈣水平。［關(guān)鍵詞］血液透析；低鈣透析液；鈣濃度［中圖分類號］R457［文獻(xiàn)標(biāo)識碼］A［文章編號］1673-7210(2011)11(c)-054-03Clinicalresearchoflow-calciumdialysateinhemodialysisGUOQi,ZHANGHong,SUNJing,WANGXuemei,WANGYujun,PANHong,WANGRong,WANGQunDepartmentofNephrology,Shando
4、ngProvincialHospitalAffiliatetoShandongUniversity,ShandongProvince,Ji'nan250012,China［Abstract］Objective:Toinvestigatehowtouselowcalciumdialysateinhemodialysispatients.Methods:43maintenancehemodialysispatientswhohadused1.25mmol/Lcalciumdialysatelongerthan6monthsweredividedintotestgroup(Tgroup)andcon
5、trolgroup(Cgroup).AccordingtodifferentiPTHlevel,TgroupweredividedintoT1(iPTH<500ng/L)andT2(iPTH^500ng/L)subgroupsandCgroupweredividedintoCl(iPTH<500ng/L)andC2(iPTH^500ng/L)subgroups.ThenthepatientsofTgroupchangedtoused1.50mmol/LcalciumdialysateandthepatientsofCgroupcontinuedtouse1.25mmol/Lcalciumdia
6、lysateforsixmonths.ThevarietyofserumiPTH,Ca,P,CaXPwerecompared.Results:Sixmonthslater,iPTHofT1subgroupdecreasedslightly,buttherewerenosignificantdifference(P>0.05).TherewerenosignificantvarietyofiPTH,Ca,PandCaXPforT1subgroup(P>0.05).iPTHandPofT2subgroupdecreasedsignificant(P<0.01,P<0.05),buttherewer
7、enosignificantvarietyofCaandCaXPforT2subgroup(P>0.05).ForClandC2subgroups,therewerenosignificantvarietyofiPTH,P,CaandCaXP(P>0.05).Conclusion:Long-termusing1.25mmol/LcalciumdialysatemayincreasePTHsecre
