中华肾病研究电子杂志
中華腎病研究電子雜誌
중화신병연구전자잡지
Chinese Journal of Kidney disease investigation (Electronic Version)
2015年
5期
246-250
,共5页
杨杰%杨聚荣%霍本刚%蔡明玉%张建国%龚文江%余燕%何娅妮
楊傑%楊聚榮%霍本剛%蔡明玉%張建國%龔文江%餘燕%何婭妮
양걸%양취영%곽본강%채명옥%장건국%공문강%여연%하아니
腹膜透析%腹膜透析液%甲状旁腺激素%钙磷代谢
腹膜透析%腹膜透析液%甲狀徬腺激素%鈣燐代謝
복막투석%복막투석액%갑상방선격소%개린대사
Peritoneal dialysis%Peritoneal dialysis solution%Parathyroid hormone%Calcium and phosphorus metabolism
目的：观察腹膜透析液钙离子浓度对持续性不卧床腹膜透析（CAPD）患者矿物质和骨代谢的影响。方法回顾性分析我院腹膜透析中心行 CAPD 治疗2年以上的123例患者，根据腹膜透析液钙离子浓度分为低钙腹膜透析液组（LCD 组，钙离子浓度为1．25 mmol／L）和标准钙腹膜透析液组（SCD 组，钙离子浓度为1．75 mmol／L），观察不同钙浓度腹膜透析液对患者血清钙、磷、全段甲状旁腺激素（iPTH）、颈动脉厚度、心脏瓣膜钙化及骨痛、皮肤瘙痒等情况的影响。使用 SPSS 18．0统计软件包进行数据处理。结果2组患者治疗前人口学特征、腹膜转运特性、钙磷代谢等指标的基线水平差异无统计学意义（P ＞0．05）。治疗2年后，2组患者血钙浓度及达标率较治疗前均显著增高（P ＜0．05），SCD 组血钙浓度增幅高于 LCD 组，但差异无统计学意义（0．26±0．31 mmol／L 与0．17±0．29 mmol／L，t ＝1．621，P ＝0．108）；2组间治疗后血清钙、磷、iPTH 平均水平及其达标率、颈动脉厚度、心脏瓣膜钙化比例、骨痛及皮肤瘙痒累计发生率差异均无统计学意义（P ＞0．05）；LCD 组活性维生素 D 使用比例显著高于 SCD 组（χ2＝6．373，P ＜0．05）。结论采用低钙与标准钙腹透液治疗2年，对 CAPD 患者矿物质和骨代谢的影响无显著性差异。
目的：觀察腹膜透析液鈣離子濃度對持續性不臥床腹膜透析（CAPD）患者礦物質和骨代謝的影響。方法迴顧性分析我院腹膜透析中心行 CAPD 治療2年以上的123例患者，根據腹膜透析液鈣離子濃度分為低鈣腹膜透析液組（LCD 組，鈣離子濃度為1．25 mmol／L）和標準鈣腹膜透析液組（SCD 組，鈣離子濃度為1．75 mmol／L），觀察不同鈣濃度腹膜透析液對患者血清鈣、燐、全段甲狀徬腺激素（iPTH）、頸動脈厚度、心髒瓣膜鈣化及骨痛、皮膚瘙癢等情況的影響。使用 SPSS 18．0統計軟件包進行數據處理。結果2組患者治療前人口學特徵、腹膜轉運特性、鈣燐代謝等指標的基線水平差異無統計學意義（P ＞0．05）。治療2年後，2組患者血鈣濃度及達標率較治療前均顯著增高（P ＜0．05），SCD 組血鈣濃度增幅高于 LCD 組，但差異無統計學意義（0．26±0．31 mmol／L 與0．17±0．29 mmol／L，t ＝1．621，P ＝0．108）；2組間治療後血清鈣、燐、iPTH 平均水平及其達標率、頸動脈厚度、心髒瓣膜鈣化比例、骨痛及皮膚瘙癢纍計髮生率差異均無統計學意義（P ＞0．05）；LCD 組活性維生素 D 使用比例顯著高于 SCD 組（χ2＝6．373，P ＜0．05）。結論採用低鈣與標準鈣腹透液治療2年，對 CAPD 患者礦物質和骨代謝的影響無顯著性差異。
목적：관찰복막투석액개리자농도대지속성불와상복막투석（CAPD）환자광물질화골대사적영향。방법회고성분석아원복막투석중심행 CAPD 치료2년이상적123례환자，근거복막투석액개리자농도분위저개복막투석액조（LCD 조，개리자농도위1．25 mmol／L）화표준개복막투석액조（SCD 조，개리자농도위1．75 mmol／L），관찰불동개농도복막투석액대환자혈청개、린、전단갑상방선격소（iPTH）、경동맥후도、심장판막개화급골통、피부소양등정황적영향。사용 SPSS 18．0통계연건포진행수거처리。결과2조환자치료전인구학특정、복막전운특성、개린대사등지표적기선수평차이무통계학의의（P ＞0．05）。치료2년후，2조환자혈개농도급체표솔교치료전균현저증고（P ＜0．05），SCD 조혈개농도증폭고우 LCD 조，단차이무통계학의의（0．26±0．31 mmol／L 여0．17±0．29 mmol／L，t ＝1．621，P ＝0．108）；2조간치료후혈청개、린、iPTH 평균수평급기체표솔、경동맥후도、심장판막개화비례、골통급피부소양루계발생솔차이균무통계학의의（P ＞0．05）；LCD 조활성유생소 D 사용비례현저고우 SCD 조（χ2＝6．373，P ＜0．05）。결론채용저개여표준개복투액치료2년，대 CAPD 환자광물질화골대사적영향무현저성차이。
Objective To investigate the effects of dialysate calcium concentrations on on mineral and bone metabolism in patients with continuous ambulatory peritoneal dialysis (CAPD).Methods A retrospective analysis was made in our hospital for more than two years in 1 23 patients with CAPD treatment, who were divided into low calcium dialysate (LCD)group (calcium concentration 1 .25 mmol/L)and standard calcium dialysate (SCD)group (calcium concentration 1 .75 mmol/L)to observe their effects on serum calcium,phosphorus,intact parathyroid hormone (iPTH),bone pain,pruritus,thickness of carotid arteries,and heart valve calcification.Results There were no differences in baseline levels of demographic characteristics,peritoneal transport characteristics,and calcium phosphorus metabolism between the two groups (P >0.05).After 2 years of treatment,serum calcium concentration and the target-reaching rate significantly increased in the two groups compared with those before treatment (P <0.05),and the calcium concentration of SCD group was higher than that of the LCD group but without statistical significance (0.26 ±0.31 mmol/L vs 0.1 7 ±0.29 mmol/L,t =1 .621 ,P =0.1 08);and the differences between the two groups after treatment were not statistically significant in the serum calcium,phosphorus,the average level of iPTH and its target-reaching rate,carotid artery thickness,cardiac valve calcification proportion,bone pain, and cumulative incidence rate of skin itching (P >0.05);but the proportion of active vitamin D use in LCD group was significantly higher than that in the SCD group (χ2 =6.373,P <0.05 ).Conclusion The treatment of CAPD with different dialysate calcium concentrations for 2 years did not have any significant effects on the mineral and bone metabolism of patients.
