CAJ | 학술논문

目的：：通过监测血清钙、磷及甲状旁腺激素( parathyroidhormone,PTH)水平,观察不同类型的磷结合剂对维持性血液透析中高磷血症患者钙磷代谢的影响。方法：选取高磷血症的透析患者60例,随机分为4组,A组患者予以安慰剂,B组患者予以口服碳酸钙(300mg Bid),C组患者予以碳酸镧(500mg Bid),D组患者予以氢氧化铝(300mg tid),持续4周。结果：①与治疗前相比,B、C、D3组患者血磷水平均明显下降(P<0.01)；A组患者血钙出现明显上升(P<0.01)；B、C组患者钙磷乘积显著下降(P<0.01)。②组间比较,C、D组患者在降低血磷、钙磷乘积及PTH水平较B组更为显著(P<0.05)。结论：3种不同类型的磷结合剂均能有效降低血磷、血PTH水平,但碳酸钙组容易导致患者血钙升高,临床上需根据患者的实际需要来选择合适的药物。
목적：：통과감측혈청개、린급갑상방선격소( parathyroidhormone,PTH)수평,관찰불동류형적린결합제대유지성혈액투석중고린혈증환자개린대사적영향。방법：선취고린혈증적투석환자60례,수궤분위4조,A조환자여이안위제,B조환자여이구복탄산개(300mg Bid),C조환자여이탄산란(500mg Bid),D조환자여이경양화려(300mg tid),지속4주。결과：①여치료전상비,B、C、D3조환자혈린수평균명현하강(P<0.01)；A조환자혈개출현명현상승(P<0.01)；B、C조환자개린승적현저하강(P<0.01)。②조간비교,C、D조환자재강저혈린、개린승적급PTH수평교B조경위현저(P<0.05)。결론：3충불동류형적린결합제균능유효강저혈린、혈PTH수평,단탄산개조용역도치환자혈개승고,림상상수근거환자적실제수요래선택합괄적약물。
Objective:To observe the effects of different types of phosphate binders for the maintenance hemodialysis patients with hyperphosphatemia, by measuring the levels of the serum calcium, phosphorus and parathyroid hormone ( PTH) . Methods:Sixty hemodialysis patients with hyperphosphatemia were investigated. The patients were divided into four groups randomly. Group A re-ceived placebo, Group B orally took calcium carbonate (300mg Bid), Group C was given lanthanum carbonate (500mg Bid), and Group D was given aluminium hydroxide (300mg tid). Results:1. Compared with those before the treatment, the levels of the serum phosphorus was obviously reduced in Group B, C and D (P<0. 01);the level of the serum calcium increased in Group A (P<0. 01);the level of the calcium-phosphorus product was significantly reduced in Group B and C (P<0. 01). 2. Compared among the four groups, Group C and Group D were more significant than group B in reducing serum phosphorus, calcium-phosphorus product and PTH levels (P<0. 01). Conclusions: All the three different types of phosphate binders can effectively reduce the serum phosphorus and PTH levels, but calcium carbonate can easily lead to hypercalcemia clinically. Therefore, we should choose the appropriate drugs according to patients' serum calcium and serum phosphorus levels.