西那卡塞治疗肾性继发性甲状旁腺功能亢进的临床疗效

发布时间：2018-03-16 09:11

本文选题：甲状旁腺功能亢进　切入点：继发性　出处：《中国新药与临床杂志》2016年12期 　论文类型：期刊论文

【摘要】：目的观察西那卡塞治疗肾性继发性甲状旁腺功能亢进(SHPT)患者的临床疗效。方法肾性SHPT患者60例分为两组,每组30例。西那卡塞组:西那卡塞起始剂量25 mg·d~(-1),每3周调整一次剂量,最大剂量100 mg·d~(-1);骨化三醇0.25μg,qn。对照组:骨化三醇每次2μg,每周2次,静脉或口服均可。疗程均为6个月。治疗期间每月监测患者血常规和血钙、磷和全段甲状旁腺激素(iPTH)水平,并记录不良反应发生情况。结果西那卡塞组完成28例,对照组患者均完成试验。治疗6个月,西那卡塞组和对照组i PTH达标率分别为82%和37%(P0.01),血钙达标率分别为100%和43%(P0.01),血磷达标率分别为50%和10%(P0.01)。与治疗前比较,西那卡塞组血钙、磷和钙磷乘积均显著降低(P0.01),而对照组血钙、磷、钙磷乘积均上升(P0.01),组间差异非常显著(P0.01)。西那卡塞组和对照组血i PTH均下降(P0.01),西那卡塞组下降幅度大于对照组(P0.01)。西那卡塞组有1例患者出现消化道症状不良反应,对照组无不良反应发生。结论与骨化三醇冲击疗法相比,西那卡塞降低SHPT患者i PTH水平更明显,同时具有降低血钙、磷、钙磷乘积的作用,且安全性较好。
[Abstract]:Objective to observe the clinical effect of cilazepine in the treatment of renal secondary hyperparathyroidism. Methods Sixty patients with renal SHPT were divided into two groups, 30 patients in each group. The maximum dose was 100 mg 路danl-1; the ossifying triol was 0.25 渭 g / g Qn.Contral group: 2 渭 g ossifying triol twice a week, intravenous or oral. The course of treatment was 6 months. The blood routine examination and serum calcium, phosphorus and the whole parathyroid hormone iPTHs were monitored monthly during the treatment period. Results 28 patients in the Sinakaser group and 28 patients in the control group completed the test, and the patients in the control group were treated for 6 months. The rates of I PTH, calcium and phosphorus were 82% and 370.01, 100% and 43, respectively, and 50% and 100.01, respectively. Compared with those before treatment, the products of calcium, phosphorus and calcium in Sinakaser group were significantly lower than those in control group, while those in control group were significantly lower than those in control group. The products of P, Ca and P were all increased (P 0.01), and the difference between the two groups was very significant (P 0.01). The serum I PTH in both the Sinakaser group and the control group was decreased (P 0.01), and the decrease was greater in the Sinakasai group than that in the control group (P 0.01). There was one patient in the Sinakaser group who had adverse reactions to digestive tract symptoms. Conclusion compared with the impact therapy of ossifying triol, Sinacarcete can decrease the level of I PTH in SHPT patients more obviously, at the same time, it can reduce the product of calcium, phosphorus, calcium and phosphorus, and the safety is better.
【作者单位】：安徽医科大学第二附属医院肾内科;
【基金】：安徽省高校省级自然科学基金(KJ2013Z155) 安徽省公益性研究联动计划项目(1604f0804021) 安徽医科大学校科研基金联合资助项目(2015xkj110)
【分类号】：R692.5;R582.1

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