低危患者应用磷酸钠盐导泻后发生高磷血症：前瞻性研究。
Hyperphosphatemia after sodium phosphate laxatives in low risk patients: prospective study.
机构信息
Department of Anesthesia, Preoperative Evaluation Section, Hospital Italiano de Buenos Aires, Rivadavia 4965, 9C, Buenos Aires, Argentina.
出版信息
World J Gastroenterol. 2009 Dec 21;15(47):5960-5. doi: 10.3748/wjg.15.5960.
AIM
To establish the frequency of hyperphosphatemia following the administration of sodium phosphate laxatives in low-risk patients.
METHODS
One hundred consecutive ASA I-II individuals aged 35-74 years, who were undergoing colonic cleansing with oral sodium phosphate (OSP) before colonoscopy were recruited for this prospective study.
EXCLUSION CRITERIA
congestive heart failure, chronic kidney disease, diabetes, liver cirrhosis, intestinal obstruction, decreased bowel motility, increased bowel permeability, and hyperparathyroidism. The day before colonoscopy, all the participants entered a 24-h period of diet that consisted of 4 L of clear fluids with sugar or honey and 90 mL (60 g) of OSP in two 45-mL doses, 5 h apart. Serum phosphate was measured before and after the administration of the laxative.
RESULTS
The main demographic data (mean +/- SD) were: age, 58.9 +/- 8.4 years; height, 163.8 +/- 8.6 cm; weight, 71 +/- 13 kg; body mass index, 26 +/- 4; women, 66%. Serum phosphate increased from 3.74 +/- 0.56 to 5.58 +/- 1.1 mg/dL, which surpassed the normal value (2.5-4.5 mg/dL) in 87% of the patients. The highest serum phosphate was 9.6 mg/dL. Urea and creatinine remained within normal limits. Post-treatment OSP serum phosphate concentration correlated inversely with glomerular filtration rate (P < 0.007, R(2) = 0.0755), total body water (P < 0.001, R(2) = 0.156) and weight (P < 0.013, R(2) = 0.0635).
CONCLUSION
In low-risk, well-hydrated patients, the standard dose of OSP-laxative-induced hyperphosphatemia is related to body weight.
目的
确定低危患者使用磷酸钠盐泻药后高磷血症的发生频率。
方法
本前瞻性研究纳入了 100 例连续的 ASA I-II 级、年龄 35-74 岁的个体，他们在结肠镜检查前接受口服磷酸钠盐（OSP）进行结肠清洁。
排除标准
充血性心力衰竭、慢性肾脏病、糖尿病、肝硬化、肠梗阻、肠蠕动减弱、肠通透性增加和甲状旁腺功能亢进。结肠镜检查前一天，所有参与者进入为期 24 小时的饮食期，包括 4 升含糖或蜂蜜的清亮液体和 90 毫升（60 克）OSP，分两次服用，每次 45 毫升，间隔 5 小时。在泻药使用前后测量血清磷酸盐。
结果
主要的人口统计学数据（平均值±标准差）为：年龄 58.9±8.4 岁；身高 163.8±8.6cm；体重 71±13kg；体重指数 26±4；女性占 66%。血清磷酸盐从 3.74±0.56mg/dL 增加到 5.58±1.1mg/dL，87%的患者血清磷酸盐超过正常值（2.5-4.5mg/dL）。最高血清磷酸盐为 9.6mg/dL。尿素和肌酐仍在正常范围内。治疗后 OSP 血清磷酸盐浓度与肾小球滤过率呈负相关（P<0.007，R²=0.0755），与总水量（P<0.001，R²=0.156）和体重（P<0.013，R²=0.0635）呈负相关。
结论
在低危、水合良好的患者中，标准剂量的 OSP 泻药引起的高磷血症与体重有关。
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