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1、血液透析患者应用低钙透析液的临床研究［摘耍］冃的：探讨维持性血液透析患者如何应用低钙透析液。方法：将43例试验前长期应用1.25mniol/L低钙透析液的维持性血液透析患者随机分入试验纟R(T组)(20例)和对照组(C组)(23例)。根据入组时血全段甲状旁腺激素(intactparathyroidhormone,iPTH)水平<500ng/L或>500ng/L,T组和C组又分别分为T1组(9例)、T2组(11例)和C1组(15例)、C2组(8例)。入组后T组改用1.50mmol/L钙浓度血液透析液，C组继续应用1.25mmol/L钙浓度血液透析液。分别在入纽时和入纽6个月后检测T纽和C组透析前
2、血iPTH水平、血钙及血磷水平,计算钙磷乘积,并进行入组前后和组间的比较。结果：T1组的血iPTH水平冇下降的趋势，但与入组前比较差异无统计学意义(P>0.05)；T1组的血钙、血磷及钙磷乘积水平与入组前比较变化均不明显(P>0.05)oT2组的血iPTH水平显著下降(PV0.01),血磷水平也冇明显下降(P<0.05)；而T2组的血钙和钙磷乘积水平无变化(P>0.05)oCl组和C2组的血iPTH水平、血钙、血磷及钙磷乘积水平与入组前比较差异均无统计学意义(P>0.05)e结论：对于伴中重度继发性甲旁亢(1PTH水平N500ng/L)、1(11钙正常或偏低的血液透析患者，长期应用1.25mm
3、ol/L浓度透析液可能加重甲状旁腺功能亢进。这类患者选择1.50mmol/L钙浓度的血液透析液有利于降低血iPTH水平，还可降低血磷水平，而不会升高血钙水平。［关键词］血液透析；低钙透析液；钙浓度［中图分类号］R457［文献标识码］A［文章编号］1673-7210(2011)11(c)-054-03Clinicalresearchoflow-calciumdialysateinhemodialysisGUOQi,ZHANGHong,SUNJing,WANGXuemei,WANGYujun,PANHong,WANGRong,WANGQunDepartmentofNephrology,Shando
4、ngProvincialHospitalAffiliatetoShandongUniversity,ShandongProvince,Ji'nan250012,China［Abstract］Objective:Toinvestigatehowtouselowcalciumdialysateinhemodialysispatients.Methods:43maintenancehemodialysispatientswhohadused1.25mmol/Lcalciumdialysatelongerthan6monthsweredividedintotestgroup(Tgroup)andcon
5、trolgroup(Cgroup).AccordingtodifferentiPTHlevel,TgroupweredividedintoT1(iPTH<500ng/L)andT2(iPTH^500ng/L)subgroupsandCgroupweredividedintoCl(iPTH<500ng/L)andC2(iPTH^500ng/L)subgroups.ThenthepatientsofTgroupchangedtoused1.50mmol/LcalciumdialysateandthepatientsofCgroupcontinuedtouse1.25mmol/Lcalciumdia
6、lysateforsixmonths.ThevarietyofserumiPTH,Ca,P,CaXPwerecompared.Results:Sixmonthslater,iPTHofT1subgroupdecreasedslightly,buttherewerenosignificantdifference(P>0.05).TherewerenosignificantvarietyofiPTH,Ca,PandCaXPforT1subgroup(P>0.05).iPTHandPofT2subgroupdecreasedsignificant(P<0.01,P<0.05),buttherewer
7、enosignificantvarietyofCaandCaXPforT2subgroup(P>0.05).ForClandC2subgroups,therewerenosignificantvarietyofiPTH,P,CaandCaXP(P>0.05).Conclusion:Long-termusing1.25mmol/LcalciumdialysatemayincreasePTHsecre
