黄力　关洁仪　陈玉平

【摘要】 目的：观察和分析血液透析与腹膜透析对尿毒症患者在钙、磷代谢中的影响。方法：选取本院2013年1月-2015年1月收治的100例尿毒症患者，采用双色球随机分组法将其分为血液透析组和腹膜透析组，每组50例，分别行血液透析和腹膜透析。对两组透析患者治疗前、治疗后3个月、6个月的钙、磷代谢情况进行观察分析。结果：血液透析组透析患者低甲状旁腺激素发生率较腹膜透析组更低，高甲状旁腺激素、高磷发生率较腹膜透析组更高（P<0.05），而两组低磷、低钙、高钙发生率比较差异均无统计学意义（P>0.05）；治疗后6个月，两组患者的甲状旁腺激素均明显低于治疗前（P<0.05），血液透析组患者治疗后的血磷水平均明显高于腹膜透析组，血钙水平均明显低于腹膜透析组，差异均有统计学意义（P<0.05）；但两组钙磷乘积比较差异均无统计学意义（P>0.05）。结论：在尿毒症患者透析治疗中，腹膜透析能更好地控制钙磷代谢，临床需结合患者实际情况，选择适宜的透析方式，合理饮食，以此实现最佳的治疗效果，提高患者生活质量。

【关键词】 尿毒症； 血液透析； 腹膜透析； 钙磷代谢

Influence Analysis of Hemodialysis and Peritoneal Dialysis on the Calcium and Phosphorus Metabolism in Patients with Uremia/HUANG Li，GUAN Jie-yi，CHEN Yu-ping.//Medical Innovation of China，2016，13（09）：040-042

【Abstract】 Objective：To observe and analyze the effects of hemodialysis and peritoneal dialysis on the calcium and phosphorus metabolism in patients with uremia.Method：One hundred patients with uremia admitted to our hospital from January 2013 to January 2015 were selected and divided into the hemodialysis group and the peritoneal dialysis group according to two color ball random grouping method，50 cases in each group.They underwent hemodialysis and peritoneal dialysis respectively.The calcium and phosphorus metabolism between the two groups before treatment，after treatment for three months，six months were observed and analyzed.Result：The incidence of low parathyroid hormone in the hemodialysis group was significantly lower than the peritoneal dialysis group，the incidence of high parathyroid hormone and high phosphorus in the hemodialysis group were significantly higher than the peritoneal dialysis group，the differences were statistically significant（P<0.05）.And there were no statistically significant differences in the incidence of low phosphorus，low calcium and high calcium between the two groups（P>0.05）.After treatment for six months，the parathyroid hormone of the two groups were significantly lower than before treatment（P<0.05），the serum phosphorus level of the hemodialysis group after treatment were significantly higher than peritoneal dialysis group，the serum calcium level of the hemodialysis group were significantly lower than the peritoneal dialysis group，the differences were statistically significant（P<0.05），but there were no statistically significant differences in the calcium-phosphorus product between the two groups after treatment（P>0.05）.Conclusion：In uremic patients for dialysis，peritoneal dialysis can better control calcium and phosphorus metabolism，clinical needs to be combined with the actual situation of patients，the appropriate choice of dialysis modality，proper diet，in order to achieve the best therapeutic effect，improve the quality of life of patients.

【Key words】 Uremia； Hemodialysis； Peritoneal dialysis； Calcium and phosphorus metabolism

First-authors address：The First Peoples Hospital of Zhaoqing City，Zhaoqing 526020，China

doi：10.3969/j.issn.1674-4985.2016.09.011

尿毒症是临床肾内科常见疾病，其不是一个独立的疾病，是各种晚期肾病共同作用的一系列综合征，多表现为水、电解质、酸碱代谢异常，胃肠道、呼吸系统、血液系统、神经肌肉系统、骨骼病变等症状，大大降低了患者的生活质量[1-2]。透析是尿毒症患者常用治疗手段，可达到净化血液、清除代谢产物、纠正水、电解质平衡紊乱的目的。钙磷代谢与透析患者心血管疾病发生、预后具有重要的作用，一旦钙磷代谢异常，将发生血管、软组织、心脏转移性钙化，增大了死亡风险。本文对100例行透析的尿毒症患者的临床资料进行分析，探讨血液透析和腹膜透析对钙磷代谢的影响，将研究结果报道如下。……