不同镁离子浓度透析液对维持性血液透析患者甲状旁腺激素的影响

摘要

目的探讨不同浓度的镁离子透析液对维持性血液透析（MHD）患者的甲状旁腺激素影响。方法选60例在潍坊市人民医院行规律血液透析的患者，随机分成A和B两组，A组以镁离子浓度为0.5mmol/L的透析液完成血液透析4周，B组以镁离子浓度为0.75mmol/L的透析液也同时完成血液透析4周。分别于研究开始前及每周的中间透析日于透析上机前抽血化验相关指标。比较不同浓度的镁离子透析液对白蛋白、钙、磷、镁、甲状旁腺激素、以及肌酐、尿素氮的影响。结果①B组患者的血清镁（sMg）的水平明显高于A组患者血清镁的水平（P＜0.01）。②B组患者PTH水平低于A组。PTH水平与血清镁水平呈负相关（r=-0.518，P＜0.05）。结论 sMg的升高在一定程度上可使PTH浓度降低。%Objective The aim was to investigate the relationship between different concentration of magnesium in dialysiate fluid and serum parathyroid hormone in MHD patients. Methods The study was carried out in 60 MHD patients of Weifang people's hospital. Patients were randomly divided into two groups:group A (MdMg group), in which patients were given dialysate fluid for four weeks which the concentration of magnesium is 0.5mmol/L. and group B (HdMg group), in which patients received hemodialysate fluid of 0.75 mmol/L dMg(dialysate magesium) consecutively. The study collected the related index before the experiment firstly and on every midweek of dialysate .Results Compared with group A, the sMg of group B was significantly higher(P<0.01), the PTH were lower. The level of sMg was negative correlation with PTH(r=-0.518, P<0.05). Conclusion The serum magnesium is relevant with PTH in MHD patients. To some extent, Hypermagnesemia inhibits PTH secretion.