慢性肾衰竭中的维生素A毒性与高钙血症
Vitamin A toxicity and hypercalcaemia in chronic renal failure.
作者信息
Farrington K, Miller P, Varghese Z, Baillod R A, Moorhead J F
出版信息
Br Med J (Clin Res Ed). 1981 Jun 20;282(6281):1999-2002. doi: 10.1136/bmj.282.6281.1999.
Serum vitamin A concentrations were measured in 38 patients undergoing haemodialysis, 24 of whom were taking multivitamin preparations containing vitamin A. Vitamin A concentrations were significantly higher in patients undergoing haemodialysis than in 28 normal controls (p less than 0.001). Patients taking vitamin A supplements had significantly higher vitamin A concentrations than those not taking them (p less than 0.05), and hypercalcaemic patients had higher concentrations than normocalcaemic patients (p less than 0.005). Withdrawal of vitamin A supplements in seven patients caused significant falls in serum vitamin A concentrations and plasma calcium concentrations (p less than 0.01 at two and three months in both cases) and in plasma alkaline phosphatase concentrations (p less than 0.01 at two months). Vitamin A toxicity can contribute to hypercalcaemia in patients undergoing haemodialysis, probably by an osteolytic effect. Multivitamin preparations containing vitamin A should therefore be prescribed with caution in these patients.
对38例接受血液透析的患者测定了血清维生素A浓度，其中24例正在服用含维生素A的多种维生素制剂。接受血液透析的患者的维生素A浓度显著高于28名正常对照者（p<0.001）。服用维生素A补充剂的患者的维生素A浓度显著高于未服用者（p<0.05），高钙血症患者的浓度高于血钙正常的患者（p<0.005）。7例患者停用维生素A补充剂后，血清维生素A浓度、血浆钙浓度（两者在2个月和3个月时p均<0.01）以及血浆碱性磷酸酶浓度（2个月时p<0.01）均显著下降。维生素A毒性可能通过溶骨作用导致接受血液透析的患者发生高钙血症。因此，对于这些患者，应谨慎开具含维生素A的多种维生素制剂。
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