透析液钙浓度对血液透析患者血清钙平衡及血压的影响.pdfVIP

层医药2007年I1月第 14卷第11期 Chin J Prim Med Pharm，Novem er 2 !． ： ： · 1789 · 透析液钙浓度对血液透析患者血清钙平衡 及血压的影响 赵金文 张丽琴 庄 凌 陈 敏 季晓琪 【摘要】 目的 探讨透析液钙浓度变化对血液透析患者透析过程中钙平衡及血压的影响，为透析患者选 择个体化的钙浓度提供依据。方法 15例血钙正常的稳定的维持性血液透析(MHD)患者分别使用钙离子 浓度1．25 nIITI。1／L(DCa 1．25)、1．5 rnn】ol／L(DCa 1．5)和1．75 mmol／1 (DCa 1 75)的透析液进行血液透析(透 析液其他成分不变)治疗4周．每次透析4．5～5 h。监测透析前、后血压，检测透析前、后血清总钙(tCa)、离子 钙(iCa)浓度。结果 使用DCa 1．25时，透析后血压及rCa、iCa均较透析前明显降低(P0．05)。使用 DCa 1 5时，透析前后血压及tCa、iCa均无明显变化(P0 05)。使用DCa 1．75时，透析后血压及 tGa、iCa均较透 析前明显升高(P0．O1)。结论 对于血压正常、透前血钙正常或轻度低血钙者，DCa 1．5的透析液是适用 的；列于MHD中出现明显高血压、高钙血症患者．应当短期使用DCa 1．25的透析液；对于 MHD中出现明显 低血压、低钙血症忠者，短期使用1)Ca 1．75的透析液是恰当的。透析液应该注重个体化的钙浓度。 【关键词】 肾功能衰竭；肾透析；钙化合物；血压 Effects of dialysate calcium concentration oll calcium balance and blood pressure of maintenance hemodialysis pa- tients ZHAO ． 1in ulf，， ．ZHANG Li—qin．ZHUANG Ling．CHENG Min， 1I Xiao—qi DelXzrtmenI oj Neph rolog3，． Huai “”Fb s，Hospita1．Nanjing Medi(“ Uniwe, sit3，．Huai “¨．diangsu 223300，China 【Abstract】 Objective Fo investigate the acute effecl c)f dialysate calcium concentration on calcium balance and blood prG~sure(BI’)of nlaintenance hemodia13tsis(MHD)patients with normal serum tCa，and to provide scien— tific basis for indIvidualized calcium concentration dialysate formula Methods For 4 weeks．dialysate with different calciunl eoncentratioils as DCa 1．25．DCa 1 5 and I)Ca 1．75 was used in 15 stable MHD patients．Artcria1 blood preasure＼vas measured before and after each dialysis session．and every 30 nlinutes during hemodialysis session Serum tota1 calcium and ionize(i calcium were assessed before and after each dialysis ses．aion with different calcjun]concen— trations dialysate Results With the DCa 1 25．BP．serum tCa and iCa decreased as compared with pre·dialysis val— ues(P0．05)．With the DCa 1．5．no significant changes of BP．serum tCa and iCa between pre·dialysis and post— dia1)，sis were found With the DCa 1 75，Bt serunl tCa and iCa increased signifi