维持性血液透析患者:高血磷、高血钙、高甲状旁腺素伴心血管钙化

摘要

2例中年男性维持性血液透析患者,在透析充分性、贫血、营养状况等指标方面无明显差异,而钙、磷、血清全段甲状旁腺激素(iPTH)指标的控制情况,两者形成鲜明对比,透析龄短的患者A血钙、磷、iPTH持续高于上限,而年龄较大的患者B透析龄长,血钙、磷、iPTH控制持续达标.经过长期随访,对比两者心血管钙化情况,慢性肾脏病矿物质与骨异常(CKD-MBD)相关血清学指标控制持续达标的患者B心血管钙化进展缓慢,血清指标持续不达标的患者A心血管钙化严重,且进展迅速.%Two middle-aged men with maintenance hemodialysis,with no significant differences in dialysis adequacy,anemia and nutritional status,has sharp contrast in the control of calcium,phosphate and iPTH.The calcium,phosphate and iPTH of the patient A continued to be higher than the upper limit,while the older patient B with longer vintage keep continuous qualified serum level of calcium,phosphate and iPT.After a long-term follow-up,comparing the cardiovascular calcification of the two patients,the patient B experienced slow progression of cardiovascular calcification,while the patient A with severe cardiovascular calcification,and progressed rapidly.