目的改善慢性肾衰竭尿毒症维持血液透析患者钙、磷、甲状旁腺代谢紊乱。方法对解放军第451 医院原有82 例患者改用高通量滤器透析治疗3 个月后，对照钙、磷、甲状旁腺素(iPTH)水平。所有患者B 超检测甲状旁腺，并进一步分为增生、非增生2 组对比此效果。结果高通量滤器透析患者血钙升高(t=-4.786,P＜0.05)，血磷、甲状旁腺素水平降低(t =2.341, P＜0.05, iPTH=2.937,P＜0.05)，甲状旁腺增生组效果更为明显(Ca:t=- 3.583/- 3.207, P=0.001/0.003; P:t=1.74/1.619, P=0.089/0.113, iPTH:t=2.408/1.830,P=0.001/0.074)。结论高通量滤器透析改善了尿毒症维持血液透析患者钙、磷、甲状旁腺代谢紊乱。

Objective To improve the abnormal changes of calcium and phosphorus and intact parathyroid hormone (iPTH) in maintenance hemodialysis (MHD) patients using high flux hemodialyzer. Methods In a total of 82 MHD patients the hemodialyzer for hemodialysis was changed from low flux hemodialyzer to high flux hemodialyzer for 3 months. Serum calcium, phosphorus and iPTH were compared before and after using high flux hemodialyzer. Patients were further divided into parathyroid hyperplasia group and normal parathyroid group based on the findings from Doppler ultrasonography. Serum calcium, phosphorus and iPTH
were further compared between the two groups. Results After using high flux hemodialyzer, serum calcium levels increased (t =-4.786, P＜0.05), and phosphorus and iPTH decreased (t =2.341, P＜0.05 for phosphorus; t =2.937, P＜0.05 for iPTH). These effects were more prominent in parathyroid hyperplasia group than in normal parathyroid group (t =-3.583/-3.207 P=0.001/0.003 for serum Ca; t =1.74/1.619, P =0.089/0.113 for serum P; t =2.408/1.830, P=0.001/0.074 for serum iPTH). Conclusion High flux hemodialyzer was better than low flux hemodialyzer to improve serum calcium and phosphorus and iPTH changes in MHD patients.