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临床研究

透析中心夜间血液透析对尿毒症患者血磷代谢的影响

  • 袁艳辉 戎殳 张翼翔 陈静 张斌 计雁飞 叶朝阳 梅长林
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  • 第二军医大学长征医院肾内科

收稿日期: 2013-08-12

  修回日期: 2013-09-11

  网络出版日期: 2014-03-12

基金资助

国家然科学基金资助项目(编号 81200542)上海市重点学科建设项目(编号 B902)

In-center nocturnal hemodialysis on phosphorus metabolism in uremic patients

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Received date: 2013-08-12

  Revised date: 2013-09-11

  Online published: 2014-03-12

摘要

【摘要】 目的 观察透析中心夜间长时血液透析(INHD)模式对尿毒症患者高磷血症的疗效。 方法 调查INHD时间6个月以上的56例患者进入INHD前1~3个月及进入INHD至2013年5月透析情况、透析前血磷、血钙、血iPTH检测值,分析血磷变化趋势,统计患者降磷药物服用情况。 结果 患者进入INHD前3个月内平均血磷水平变化无统计学差异,进入INHD后1个月平均血磷水平即显著下降(p<0.05),之后持续稳定在<1.67mmol/L水平;进入INHD后,有15例患者的31次(6.5%)检测出现低磷血症,发生过低磷血症的患者年龄更大、体重指数(BMI)更低、接受NHD时间更长(p<0.05);进入INHD后有14例(25%)患者停用降磷药物。 结论 INHD能持续、平稳、有效地控制透析患者高磷血症,低磷血症发生率较低。

本文引用格式

袁艳辉 戎殳 张翼翔 陈静 张斌 计雁飞 叶朝阳 梅长林 . 透析中心夜间血液透析对尿毒症患者血磷代谢的影响[J]. 中国血液净化, 2014 , 13(03) : 140 -142 . DOI: 10.3969/j.issn.1671-4091.2014.03.004

Abstract

Objective To observe the effect of in-center nocturnal hemodialysis (INHD) on hyperphosphatemia in uremic patients. Methods fifty-six patients who received INHD more than 6 months were investigated. The predialysis serum phosphorus, serum calcium and serum iPTH before and after entering INHD were collected. And the uses of phosphate binders were recorded. Results Within the 3 months before entering INHD, there was no significant difference in average serum phosphate levels. The average phosphorus levels significantly decreased (p<0.05) from 1 month after entering INHD and was steady at <1.67 mmol/L. Hypophosphatemia were detected in 31 cases (6.5%) of 15 patients. It occurred in patients with older age, less body mass index (BMI) and longer NHD duration (p<0.05). After entering INHD, withdrawal of phosphate binders were observed in 14 patients (25%). Conclusion INHD can effectively and stably control hyperphosphatemia in dialysis patients,whit the lower prevalence of  hypophosphatemia .
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