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目前认为,来自制备透析液的自来水中的铝是透析性脑病和抗维生素D骨软化症的主要原因。Elliott和Macdugall首先观察到,在这些问题发生之前,先有严重贫血,其后即确定此种贫血是小细胞贫血,不是缺铁所致。在我们以前的长期透析病人中,透析性脑病、骨软化症和伴发的小细胞贫血之发病率较高,他们所用的透析液均由含铝量较高的非治疗用自来水制得。我们对15例从A透析区转到B透析区治疗的病人作了前瞻性研究,检查他们的血相和血铝含量。B透析区用以制备透析液的水均经去离子处理,使铝含量降低。我们发现在A透析区治疗的病人,血清铁蛋
It is currently believed that aluminum in tap water from which dialysate is prepared is the main cause of dialysis encephalopathy and anti-vitamin D osteomalacia. Elliott and Macdugall first observed that before these problems occurred, severe anemia was first identified, followed by the determination of such anemia as small cell anemia, not iron deficiency. Among our former long-term dialysis patients, the incidence of dialysis encephalopathy, osteomalacia and associated small cell anemia was high, and the dialysate they used was prepared from non-therapeutic tap water containing a higher amount of aluminum. We conducted a prospective study of 15 patients who switched from A dialysis to B dialysis and examined their blood and blood aluminum levels. The dialysate used to prepare the dialysate is deionized to reduce the aluminum content. We found that patients treated in dialysis area A, serum ferritin