摘要
目的探讨透析液钙离子浓度对低甲状旁腺素(PTH)腹膜透析患者骨代谢的影响。方法回顾性分析56例低PTH且行持续不卧床腹膜透析患者的临床资料,其中所用透析液钙离子浓度为1.25mmol/L 31例,为低钙腹膜透析液(LCD)组;1.50mmol/L 25例,为标准钙腹膜透析液(SCD)组。连续观察并比较两组患者初次、二次(3个月后)、三次(6个月后)腹膜透析时血清骨代谢指标Ⅰ型胶原交联氨基末端肽(NTX)、骨钙素(BGP)、骨碱性磷酸酶(BALP)及相关指标(血钙、磷、PTH水平)。结果在初次评估时,两组患者血清骨代谢指标及相关指标比较,差异均无统计学意义(均P>0.05);在二、三次评估时,SCD组患者血清骨代谢指标及PTH水平低于LCD组(均P<0.05),钙、磷水平高于LCD组(均P<0.05)。组内比较发现,随着腹膜透析时间延长,两组患者血清骨代谢指标均明显升高(均P<0.05);LCD组磷水平有所下降(P<0.05),PTH水平升高(P<0.05);SCD组钙水平升高(P<0.05),而磷、PTH水平差异均无统计学意义(均P>0.05)。结论对低PTH腹膜透析患者使用LCD,能有效改善高血磷和低转运骨代谢状态,且不增加低血钙的发生风险。
Objective To investigate the effect of calcium concentration in dialysate on bone metabolism in patients with low parathyroid hormone(PTH)under peritoneal dialysis.Methods The clinical data of 56 patients with low PTH under continuous ambulatory peritoneal dialysis were retrospectively analyzed.Among them,31 cases had dialysate calcium concentration of 1.25mmol/L(LCD)group,and 25 cases had the standard calcium concentration in dialysate(1.50mmol/L,SCD group).The serum type I collagen cross-linked amino terminal peptide(NTX),osteocalcin(BGP),bone alkaline phosphatase(BALP)and related indicators(blood calcium,phosphorus,PTH levels)in baseline,3 months and 6 months after peritoneal dialysis were measured and compared between two groups.Results There was no significant difference in baseline serum bone metabolism indexes and related indicators between the two groups(both P>0.05).During the second or third assessment,the serum bone metabolism indexes and PTH levels were lower,while the calcium and phosphorus levels were higher in SCD group than those in LCD group(all P<0.05).With the extension of the peritoneal dialysis time,the serum bone metabolism indexes of the two groups were significantly increased(both P<0.05).In the LCD group,the level of phosphorus decreased(P<0.05),and the level of PTH increased(P<0.05).In the SCD group,the calcium level increased(P<0.05),but there was no difference in the phosphorus and PTH level(P>0.05).Conclusion The use of LCD dialysate in patients with low PTH under peritoneal dialysis can effectively improve the hyperphosphatemia and low calcium transport in bone metabolism without increasing the risk of hypocalcemia.
作者
魏伟
谢祥成
费晓
王鸣
WEI Wei;XIE Xiangcheng;FEI Xiao(Department of Nephrology,the Affiliated Hangzhou First People’s Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China)
出处
《浙江医学》
CAS
2020年第7期694-696,共3页
Zhejiang Medical Journal
关键词
腹膜透析
甲状旁腺素
钙浓度
骨代谢
Peritoneal dialysis
Parathyroid hormone
Calcium concentration
Bone metabolism
