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慢性肾衰后期,经血液透析或腹透析的患者以及未经透析但口服铝盐治疗的患者可发生各组织铝的蓄积并出现高铝血症和中毒并发症.血清和组织中铝含量高是小肠吸收口服铝盐和透析液中的铝所致.铝可抑制二氢喋啶还原酶活性,使脑中四氢生物喋呤、酪氨酸和神经递质浓度降低以及胆硷能神经传导的主要突触后酶活性改变而毒害神经.虽然正确的机理仍待阐明,但很多证据说明,铝对功能性肾单位减少的患者的神经有毒害作用,后者导致肾对铝的清除率降低,随之而来血清各组织中铝浓度增加. 透析性骨营养不良的骨质软化,易发生骨折,因而是临床的重要问题.同大量的铝接触
In the later stages of chronic renal failure, aluminum accumulation in the tissues and complications of hyperlipidemia and poisoning can occur in patients undergoing hemodialysis or dialysis, as well as in patients who have not been treated with dialysis but with oral aluminum salts. The high aluminum content in serum and tissues is The small intestine absorbs oral aluminum salts and the aluminum in the dialysate.Aluminum inhibits dihydropteridine reductase activity, lowering the concentration of tetrahydrobiopterin, tyrosine and neurotransmitters in the brain, and cholinergic nerve conduction Although the correct mechanism remains to be elucidated, there is much evidence that aluminum has a detrimental effect on the nerves of patients with functional nephrons, which leads to a decrease in renal clearance of aluminum, Followed by an increase in the serum concentration of aluminum in each tissue. Dialysis osteodystrophy osteomalacia, prone to fracture, and therefore is an important clinical issue with a large number of aluminum exposure