目的：观察不同超滤量及透析液钙浓度对透析前后血钙的影响。方法：将92名血液透析患者按照使用透析液的Ca2+浓度分为Ca-1.25组和Ca-1.5组，每组再按照透析超滤量分为两个亚组，Ca-1.25组分为A，B组，Ca-1.5组分为C，D组，A组、C组超滤量<3 kg，B组、D组超滤量≥3 kg。检测透析前后各组血清总钙、血磷、透前甲状旁腺激素(plasma parathyroid hormone，PTH)浓度并进行相关分析。结果：各组透析后血钙浓度较透析前升高，差异具有统计学意义(P<0.01)，B组、D组透析前后血钙变化分别较A组、C组明显，差异具有统计学意义(P<0.01)，Ca-1.5组血钙较Ca-1.25组高，两组透析前后血钙变化差异无统计学意义。A，B组及C，D组中血磷及PTH均无差异，Ca-1.25组血磷及PTH均高于Ca-1.5组，差异具有统计学意义(P<0.05)。结论：使用1.25和1.5 mmol/L的Ca2+透析液均会使钙向体内转运，超滤量与钙转运量成正比，与血磷变化无关，且使用1.5 mmol/L的Ca2+透析液的患者血钙更易达到正常水平，不刺激PTH分泌。
Effect of ultrafiltration volume and dialysate calcium concentration on serum calcium in pre- and post-hemodialysis
Objective: To investigate the effect of different ultrafiltration volume and dialysate calcium concentration on serum calcium in pre- and post-hemodialysis in maintenance hemodialysis patients. Methods: Ninety-two patients were divided into Ca-1.25 group and Ca-1.5 group according to their dialysate calcium concentration, and they were divided into subgroups according to ultrafiltration volume respectively, A, B subgroups belong to Ca-1.25 group, and C, D subgroups belong to Ca-1.5 group, patients with ultrafiltration volume less than 3.0 kg were as subgroup A in Ca-1.25 group and subgroup C in Ca-1.5 group, patients with ultrafiltration volume equal or greater than 3.0 kg were as subgroup B in Ca-1.25 group and subgroup D in Ca-1.5 group. To measure serum calcium, serum phosphate and plasma parathyroid hormone (PTH) concentrations in pre- and post-hemodialysis respectively were detected and analyzed. Results: Serum calcium concentrations were higher in post- than that in pre- hemodialysis, the difference was statistically significant (P<0.01), variations of them were more obvious in B and D subgroups than those in A and C subgroups, the difference was statistically significant (P<0.01), and there were no significant differences in Ca-1.25 group and Ca-1.5 group, and in Ca-1.5 group they were higher than in Ca-1.25 group. Serum phosphate and PTH were no differences in A and B subgroups , C and D subgroups, and were higher in Ca-1.25 group than in Ca-1. 5 group, P<0.05. Conclusion: Calcium mass transfers from dialysate to blood during the hemodialysis using dialysate containing 1.25 mmol/L or 1.5 mmol/L calcium, ultrafiltration volumes are positively related with variations of serum calcium concentrations, but no relation with variations of serum plasma concentrations, and using dialysate containing 1.5 mmol/L calcium make patients more healthy.