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目的:探讨低钙透析对维持性血液透析(MHD)患者微炎症状态的影响。方法:选择104例透析时间超过3个月的MHD合并高磷血症患者,观察期间无急、慢性炎症及其他活动性疾病,随机分为对照组(54例)和低钙组(50例),两组均进行规律透析(3次/周),对照组给予正常钙透析液(1.50mmol/L),低钙组给予低钙透析液(1.25mmol/L),观察6个月,分别检测观察前后患者超敏C反应蛋白(hs-CRP)及血清钙、磷等生化指标。结果:观察前两组患者的hs-CRP分别为(5.82±0.94)mg/L和(6.17±0.97)mg/L(P>0.05),观察后对照组患者的hs-CRP为(5.29±0.77)mg/L,与观察前相比较无显著差异(P>0.05),低钙组患者的hs-CRP为(2.84±0.68)mg/L,与观察前及观察后的对照组相比均显著下降(P<0.01),同时血磷和钙磷乘积也较对照组和观察前明显下降(P<0.05)。结论:低钙透析可改善MHD微炎症状态,可能与改善钙磷代谢紊乱有关。
Objective: To investigate the effect of low calcium dialysis on microinflammatory state in maintenance hemodialysis (MHD) patients. Methods: 104 patients with MHD complicated with hyperphosphatemia who had been dialysis for more than 3 months were selected and randomly divided into control group (n = 54) and hypocalcemia group (n = 50) with no acute or chronic inflammation and other active diseases during the observation period. , And regular dialysis (3 times / week) in both groups. The control group was given normal calcium dialysate (1.50mmol / L), the low calcium group was given low calcium dialysate (1.25mmol / L) for 6 months. Before and after observation of patients with high-sensitivity C-reactive protein (hs-CRP) and serum calcium, phosphorus and other biochemical indicators. Results: The hs-CRP in the first two groups were (5.82 ± 0.94) mg / L and (6.17 ± 0.97) mg / L, respectively. The hs-CRP in the control group was (5.29 ± 0.77 ) mg / L, there was no significant difference (P> 0.05) compared with those before the observation. The hs-CRP in the low calcium group was (2.84 ± 0.68) mg / L, which was significantly higher than that before the observation and after the observation (P <0.01). At the same time, the product of phosphorus and calcium decreased significantly (P <0.05) compared with the control group and before the observation. Conclusion: Low calcium dialysis can improve the microinflammatory state of MHD, which may be related to the improvement of disorders of calcium and phosphorus metabolism.