中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2012年
1期
21-24
,共4页
程叙扬%甘红兵%吕继成%王芳%左力
程敘颺%甘紅兵%呂繼成%王芳%左力
정서양%감홍병%려계성%왕방%좌력
炭%透析%高磷血症
炭%透析%高燐血癥
탄%투석%고린혈증
Charcoal%Dialysis%Hyperphosphataemia
目的 研究口服药用活性炭对未能控制的高磷血症透析患者血磷与钙磷乘积的作用.方法 采用单中心、前瞻性、自身前后对照研究.经含钙的磷结合剂治疗后仍存在高磷血症的血液透析或腹膜透析患者,餐中加服药用活性炭4.5～7.2 g/d治疗3个月.检测治疗前后血磷、钙、钙磷乘积、全段甲状旁腺激素( iPTH)、白蛋白、血红蛋白水平.用配对t检验进行统计学分析.结果 与治疗前比较,治疗3个月后患者血磷水平显著下降[(1.85±0.30)mmol/L比(2.16±0.34) mmol/L,P＜0.01]；血钙磷乘积也相应显著下降[(54.12±8.37) mg2/dl2比(63.93±8.83) mg2/dl2,P＜0.01]；有更多并发继发性甲状旁腺功能亢进症的患者可以接受维生素D治疗(83.3％比50％)；血钙与iPTH水平无显著性变化(P=0.734,0.665).活性碳治疗期间血白蛋白水平较前下降[(40.1±2.2)g/L比(41.7±2.9) g/L,P=0.001].结论 顽固性高磷血症透析患者在继续原有磷结合剂治疗基础上,口服药用活性炭可以有效地降低血磷水平与钙磷乘积,对血钙及iPTH水平没有显著性影响.活性炭治疗可使患者血白蛋白水平轻度下降.
目的 研究口服藥用活性炭對未能控製的高燐血癥透析患者血燐與鈣燐乘積的作用.方法 採用單中心、前瞻性、自身前後對照研究.經含鈣的燐結閤劑治療後仍存在高燐血癥的血液透析或腹膜透析患者,餐中加服藥用活性炭4.5～7.2 g/d治療3箇月.檢測治療前後血燐、鈣、鈣燐乘積、全段甲狀徬腺激素( iPTH)、白蛋白、血紅蛋白水平.用配對t檢驗進行統計學分析.結果 與治療前比較,治療3箇月後患者血燐水平顯著下降[(1.85±0.30)mmol/L比(2.16±0.34) mmol/L,P＜0.01]；血鈣燐乘積也相應顯著下降[(54.12±8.37) mg2/dl2比(63.93±8.83) mg2/dl2,P＜0.01]；有更多併髮繼髮性甲狀徬腺功能亢進癥的患者可以接受維生素D治療(83.3％比50％)；血鈣與iPTH水平無顯著性變化(P=0.734,0.665).活性碳治療期間血白蛋白水平較前下降[(40.1±2.2)g/L比(41.7±2.9) g/L,P=0.001].結論 頑固性高燐血癥透析患者在繼續原有燐結閤劑治療基礎上,口服藥用活性炭可以有效地降低血燐水平與鈣燐乘積,對血鈣及iPTH水平沒有顯著性影響.活性炭治療可使患者血白蛋白水平輕度下降.
목적 연구구복약용활성탄대미능공제적고린혈증투석환자혈린여개린승적적작용.방법 채용단중심、전첨성、자신전후대조연구.경함개적린결합제치료후잉존재고린혈증적혈액투석혹복막투석환자,찬중가복약용활성탄4.5～7.2 g/d치료3개월.검측치료전후혈린、개、개린승적、전단갑상방선격소( iPTH)、백단백、혈홍단백수평.용배대t검험진행통계학분석.결과 여치료전비교,치료3개월후환자혈린수평현저하강[(1.85±0.30)mmol/L비(2.16±0.34) mmol/L,P＜0.01]；혈개린승적야상응현저하강[(54.12±8.37) mg2/dl2비(63.93±8.83) mg2/dl2,P＜0.01]；유경다병발계발성갑상방선공능항진증적환자가이접수유생소D치료(83.3％비50％)；혈개여iPTH수평무현저성변화(P=0.734,0.665).활성탄치료기간혈백단백수평교전하강[(40.1±2.2)g/L비(41.7±2.9) g/L,P=0.001].결론 완고성고린혈증투석환자재계속원유린결합제치료기출상,구복약용활성탄가이유효지강저혈린수평여개린승적,대혈개급iPTH수평몰유현저성영향.활성탄치료가사환자혈백단백수평경도하강.
Objective To study the effect of medically activated charcoal on serum phosphorus level and calcium-phosphorus products in dialysis patients with poorly controlled hyperphosphatemia. Methods A single-center,prospective,self-controlled study was performed.Medically activated charcoal was administered 4.5-7.2 g per day with meals for three months to hemodialysis or peritoneal dialysis patients with hyperphosphatemia after taking calcium-based phosphate binders.The levels of blood phosphorus,calcium,calcium-phosphorus products,intact parathyroid hormone (iPTH),albumin and hemoglobin were detected before and after the treatment.The results were analyzed using paired t-test. Results After 3 months of treatment,the patients' serum phosphorus level was significantly reduced from (2.16 ±0.34) mmol/L (pretreatment) to (1.85±0.30) mmol/L (post-treatment) (P＜0.01).Similarly,the serum calciumphosphorus products were lowered from pre-treatment level of (63.93 ±8.83) mg2/dl2 to posttreatment of (54.12±8.37) mg2/dl2 (P＜0.01).Serum albumin level was slightly reduced from (41.7±2.9) g/L to (40.1±2.2) g/L (P=0.001).In contrast,there were no significant changes in serum calcium and iPTH levels when compared pre- to post-treatment values (P=0.734 and P=0.665,repectively). Conclusion In combination with calcium-based phosphate binder therapy,oral medically activated charcoal can effectively reduce the levels of blood phosphorus and calciumphosphorus products in dialysis patients with refractory hyperphosphatemia.
