CAJ | 학술논문

目的：探讨低钙透析联合高通量透析（ HFHD）对透析患者颈动脉钙化的影响。方法：将36例维持性血液透析（ MHD）患者随机分为A组（使用高通量透析器）和B组（使用低通量透析器），两组均为低钙透析，共观察12个月。观察治疗前后两组颈动脉内-中膜厚度（IMT）、生化指标、血压、碳酸钙和活性维生素D3用量变化，记录不良反应。结果：（1） A组颈动脉IMT轻微增加，B组IMT明显增加，两组比较差异有统计学意义；（2）两组血钙、磷均有降低，A组较明显，B组甲状旁腺素（iPTH）明显升高，A组营养及炎症指标、血压改善优于B组；（3）两组碳酸钙及活性维生素D用量均增加；（4）无严重不良反应发生。结论：低钙透析联合高通量透析可改善血管钙化危险因素，延缓血管钙化的发生发展，可成为一种有效、安全且经济的治疗方法。
목적：탐토저개투석연합고통량투석（ HFHD）대투석환자경동맥개화적영향。방법：장36례유지성혈액투석（ MHD）환자수궤분위A조（사용고통량투석기）화B조（사용저통량투석기），량조균위저개투석，공관찰12개월。관찰치료전후량조경동맥내-중막후도（IMT）、생화지표、혈압、탄산개화활성유생소D3용량변화，기록불량반응。결과：（1） A조경동맥IMT경미증가，B조IMT명현증가，량조비교차이유통계학의의；（2）량조혈개、린균유강저，A조교명현，B조갑상방선소（iPTH）명현승고，A조영양급염증지표、혈압개선우우B조；（3）량조탄산개급활성유생소D용량균증가；（4）무엄중불량반응발생。결론：저개투석연합고통량투석가개선혈관개화위험인소，연완혈관개화적발생발전，가성위일충유효、안전차경제적치료방법。
Objective:To explore the effect of low calcium dialysis combination with high-flux hemodialysis on carotid cal-cification in hemodialysis patients. Methods:36 patients on maintenance hemodialysis( MHD) with low calcium dialysis for 12 months were randomly divided into group A( high flux dialyzer)and group B( low -flux dialyzers). Carotid intimae -media thickness( IMT),biochemical parameters,blood pressure,the amount of calcium and active vitamin D3 were observed before and af-ter treatment. Results:(1)Group A increased slightly in carotid IMT while significantly increased by group B,there were statistical differences between two groups;(2)Serum of calcium,phosphorus were lower in two groups,especially in group A,while intact par-athyroid hormone( iPTH)increased significantly in group B. Nutrition and inflammatory makers,blood pressure were improved better in group A than in group B.(3)The amounts of calcium and active vitamin D were increased in two groups;(4)No serious adverse events happened. Conclusion:Low calcium dialysis with HFHD can improve risk factors for vascular calcification,delay the develop-ment of vascular calcification,can be an effective,safe and economical method of treatment.