Ermakova I P, Sokolova T Iu, Pronchenko I A, Biriukova L S, Ermolenko A E, Levitskiĭ E R
Ter Arkh. 1991;63(6):75-8.
Overall 34 patients with terminal renal failure (TRF) and 81 recipients of the allotransplanted cadaveric kidney (ACK) were examined. It has been established in in-vitro experiments with modulated by additions of EDTA to the plasma and CaCl2 hypo- and hypercalcemia that the magnitude of bound calcium (standardized at the concentration of ionized calcium-Ca++1 mmol/l) decreased in the blood plasma in 65 and 61% of cases. Besides protein-bound calcium dropped in 94 and 91% of cases; the total buffer capacity of the plasma and buffer capacity of proteins fell in 59 and 87% of cases in TRF and ACK, respectively. The rise of the Ca++ content on an empty stomach seen in 21 out of 99 patients with TRF and in 42 out of 98 recipients of the ACK was caused by a decrease of calcium binding in the blood plasma, not made for by the fall of calcium supply to the blood because of "tertiary" hyperparathyroidism. Hypocalcemia detected in 38% of TRF patients was consequence to the rise of calcium binding not made for by the increased calcium supply to the blood provoked by bone resistance to parathyroid hormone.
总共对34例终末期肾衰竭（TRF）患者和81例同种异体移植尸体肾（ACK）受者进行了检查。在体外实验中，通过向血浆中添加乙二胺四乙酸（EDTA）和氯化钙来调节低钙血症和高钙血症，结果发现，在65%和61%的病例中，血浆中结合钙的量（以离子钙浓度Ca++1 mmol/l为标准）下降。此外，在94%和91%的病例中，蛋白质结合钙下降；在TRF和ACK患者中，血浆的总缓冲能力和蛋白质的缓冲能力分别在59%和87%的病例中下降。99例TRF患者中有21例、98例ACK受者中有42例空腹时Ca++含量升高，这是由于血浆中钙结合减少所致，而非因“三期”甲状旁腺功能亢进导致血液中钙供应减少。在38%的TRF患者中检测到的低钙血症是由于骨骼对甲状旁腺激素产生抵抗，导致血液中钙供应增加，但钙结合增加所致。
