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目的评价透析日碳酸钙联合非透析日碳酸镧治疗维持性血液透析患者非低血钙、高磷血症的有效性、安全性及经济性。方法 38例行规律血液透析治疗合并非低血钙、高磷血症的患者,其中合并高钙血症12例。每月检测患者的血钙、血磷、血甲状旁腺激素(血iPTH)、软组织钙化和电解质变化。结果治疗后,患者血磷、血iPTH水平变化优于治疗前(P<0.05);治疗前后心脏瓣膜钙化程度变化情况比较差异无统计学意义(P>0.05);患者碳酸钙平均摄入量约为1250 mg/d,碳酸镧平均摄入量约为1500 mg/d;无血钙升高及低血钙,1例有腹痛症状,但可以耐受坚持试验。结论透析日碳酸钙联合非透析日碳酸镧降血磷效果较好,临床耐受性较好,对血钙影响小,恶心、呕吐、便秘等不良反应发病率较低,且经济性较好。
Objective To evaluate the effectiveness, safety and economy of non-hypocalcemia and hyperphosphatemia in maintenance hemodialysis patients on the dialysis day combined with lanthanum-a-non-dialysis day. Methods 38 regular hemodialysis patients with non-hypocalcemia, hyperphosphatemia, including 12 cases of hypercalcemia. Patients were tested monthly for serum calcium, phosphorus, parathyroid hormone (iPTH), changes in soft tissue calcification and electrolytes. Results After treatment, the levels of serum phosphorus and blood iPTH were better than those before treatment (P <0.05). There was no significant difference in the changes of heart valve calcification between before and after treatment (P> 0.05). The average calcium intake For 1250 mg / d, lanthanum carbonate average intake of about 1500 mg / d; no elevated serum calcium and hypocalcemia, 1 case of abdominal pain symptoms, but can withstand adherence to the test. Conclusions Dialysis day calcium carbonate combined with non-dialysis day lanthanum carbonate hypophosphatemic effect is better, clinical tolerance is better, little effect on blood calcium, nausea, vomiting, constipation and other adverse reactions incidence is low, and the economy is better.