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1、54南昌大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)20I4年第54卷第4期JournalofNanchangUniversity(MedicalSciences)2014。Vo1.54No.4不同的鈣濃度透析液對(duì)維持性血液透析合并難治性高血壓的影響周娟,肖劍,傅中偉(璧山縣人民醫(yī)院腎內(nèi)科,重慶璧山402760)摘要:目的探討不同的鈣濃度透析液對(duì)維持性血液透析(MHD)合并難治性高血壓的影響。方法34例MHD合并難治性高血壓患者按鈣濃度透析液的不同分為2組:觀察組和對(duì)照組,每組l7例。觀察組采用鈣濃度為1.25mmol·I透析液行血液透析治療,對(duì)照組采用鈣濃度為1.5
2、0mmol·I透析液行血液透析治療。觀察2組治療前、治療3個(gè)月后血壓(SBP、DBP)、平均動(dòng)脈壓(MAP)及血清鈣、磷和全段甲狀旁腺激素(iPTH)水平的變化情況。結(jié)果對(duì)照組治療前、治療3個(gè)月后SBP、DBP、MAP和血清iPTH水平均無明顯變化(均P>0.05);觀察組治療3個(gè)月后SBP、DBP和MAP水平均較治療前、對(duì)照組顯著下降(均P<0.05),血清iPTH水平較治療前、對(duì)照組明顯升高(P0.05)。結(jié)論在充分血液透析、合理聯(lián)合應(yīng)用降壓藥等措施的基礎(chǔ)上,低鈣透析
3、液透析有助于MHD患者高血壓的控制,且低鈣透析液透析是另一種有效的治療措施。關(guān)鍵詞:低鈣濃度透析液;維持性血液透析;難治性高血壓;血壓;鈣磷代謝;全段甲狀旁腺激素中圖分類號(hào):R459.5;R544.1文獻(xiàn)標(biāo)志碼:A文章編號(hào):2095-4727(2014)04-0054-03EffectsofDialysateCalciumConcentrationsonMaintenanceHemodialysisComplicatedbyRefractoryHypertensionZHOUJuan,XIAOJian,F(xiàn)UZhong-wei(Departme
4、ntof’Nephrology,BishanCountyPeople’SHospital,Bishan402760,China)ABSTRACT:ObjectiveToexploretheeffectsofdialysatecalciumconcentrationsonmaintenancehemodialysis(MHD)complicatedbyrefractoryhypertension(RH).MethodsThirty—fourMHDpatientswithRHwererandomlytreatedwithhemodialysisa
5、tacalciumconcentrationof1.50mmol·L(controlgroup,n一17)or1.25mmol·I(observationgroup,n一17).Systolicbloodpressure(SBP)。diastolicbloodpressure(DBP),meanarterialpressure(MAP)andserumlevelsofcalcium,phosphorusandintactparathyroidhormone(iPTH)weremeasuredbeforeand3monthsaftertreat
6、ment.ResultsNoobviouschangesinSBP,DBP,MAPandserumiPTHlevelswerefound3monthsaftertreatmentincontrolgroup(P>0.05).Inobservationgroup,SBP,DBPandMAPlevelsdecreasedbutserumiPTHlevelsincreased3monthsaftertreatment(P<0.O5).Comparedwithcontro1group,SBP。DBPandMAP1evelsdecreasedbutse
7、rumiPTHlevelsin—creasedinobservationgroup(P<0。05).Nosignificantchangesinserumlevelsofcalciumandphosphoruswerefound3monthsaftertreatmentinbothgroups(P>0.05).ConclusionOnthebasisofadequatehemodialysisandcombinedapplicationofantihypertensivedrugs,lowcalciumdialysatecontributes
8、tothecontrolofhypertensioninMHDpatients.Therefore,lOWcalciumdia—lysateisaneffectiv