骨化三醇、西那卡塞联合护理干预对MHD患者SHPT血清成纤维细胞生长因子23的影响

发布时间：2018-05-25 10:30

本文选题：骨化三醇 + 西那卡塞　；参考：《海南医学院学报》2016年24期

【摘要】：目的:探讨骨化三醇、西那卡塞联合护理干预对维持性血液透析(MHD)患者继发性甲状旁腺功能亢进(SHPT)血清成纤维细胞生长因子23(FGF23)的影响。方法:选取我院收治的SHPT患者90例为研究对象,随机分为观察组和对照组。两组均给予护理干预,于进食时吞服盐酸西那卡塞,开始剂量为25mg/d,每2~4周根据全段甲状旁腺激素(iPTH)、钙(Ca)、磷(P)水平调整剂量,最大剂量不超过75mg/d,观察组在上述治疗基础上口服骨化三醇胶丸0.25μg/d,3次/周,两组均治疗3个月后进行效果评价。两组治疗前后采集清晨空腹外周静脉血,采用比色法测定Ca、P,ELISA法测定iPTH及血清FGF23、骨特异性碱性磷酸酶(BSAP),全自动生化检测仪测定血肌酐(Scr)、尿毒氮(BUN),单室尿素动力学模型进行量化分析检测尿素清除指数(KT/V)。结果:观察组治疗后Ca升高程度,P、iPTH降低程度大于对照组(P0.05),两组治疗后BUN、Scr、KT/V无明显变化(P0.05),观察组治疗后FGF23、BSAP水平降低程度大于对照组(P0.05)。结论:骨化三醇、西那卡塞联合护理干预治疗MHD患者SHPT,可有效降低PTH、FGF23、BSAP水平,改善临床症状。
[Abstract]:Objective: to investigate the effect of ossifying triol and combined nursing intervention with Sinakaser on serum fibroblast growth factor 23 FGF23 in secondary hyperparathyroidism parathyroid hyperparathyroidism (SHPTT) patients with maintenance hemodialysis (HD). Methods: 90 patients with SHPT were randomly divided into observation group and control group. The two groups were given nursing intervention. The initial dose was 25mg / d. The dose was adjusted every 2 weeks according to the levels of the whole level of parathyroid hormone iPTHG, calcium, phosphoric acid. The maximum dose was not more than 75 mg / d. The observation group took 0.25 渭 g / d of oscitic triol colloidal pill three times a week on the basis of the above treatment. The effect was evaluated after 3 months of treatment in both groups. Fasting peripheral venous blood was collected before and after treatment in both groups. IPTH and serum FGF23 were determined by colorimetric method, bone specific alkaline phosphatase (BSAP), serum creatinine (creatinine), urinary nitrogen bun, urea clearance index (KT / V) were determined by single chamber urea kinetic model. Results: the degree of Ca increase in the observation group was higher than that in the control group (P 0.05), but there was no significant change in KT / V between the two groups after treatment. The decrease of the level of FGF23 / BSAP in the observation group was higher than that in the control group (P 0.05). Conclusion: combined nursing intervention of ossifying triol and Sinakaser can effectively reduce the level of FGF23 BSAP and improve clinical symptoms in patients with MHD.
【作者单位】：河北北方学院附属第二医院五官科病房;河北北方学院附属第二医院肾内科;
【基金】：张家口市科学技术和地震局计划项目(1521095D)~~
【分类号】：R473.5

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