帕立骨化醇治疗终末期肾脏病继发性甲状旁腺功能亢进症的系统评价

发布时间：2018-05-04 03:08

本文选题：帕立骨化醇 + 继发性甲状旁腺功能亢进症　；参考：《吉林大学》2014年硕士论文

【摘要】：目的：系统评价帕立骨化醇治疗终末期肾脏病继发性甲状旁腺功能亢进症的安全性及有效性。方法：应用计算机检索Pubmed数据库、Embase数据库、Cochrane图书馆对照试验的中心资料库、万方数据库、重庆维普数据库、相关期刊论文（CNKI），时间截止至2013年12月。收集帕立骨化醇治疗ESRD继发性甲状旁腺功能亢进症的随机对照试验，应用Rev Man5.2软件对数据进行Meta分析。结果：共纳入文献6篇，共564例患者。研究结果显示：有效性分析：帕立骨化醇组iPTH达标率高于活性维生素D组[RR=1.15，，95％CI(1.02，1.29)，P=0.02]。帕立骨化醇组iPTH下降幅度大于活性维生素D组，但无统计学意义[WMD=-8.36，95％CI(-20.17，3.46)，P=0.17]。安全性分析：帕立骨化醇组高钙血症发生率小于活性维生素D组[RR=0.45，95%CI（0.30，0.66），P＜0.0001]。帕立骨化醇组钙磷乘积升高幅度小于活性维生素D组[WMD=-0.06，95%CI（-0.09，-0.03），P=0.0003]。帕立骨化醇组与活性维生素D组高磷血症发生率、血清钙、磷变化幅度相似（P＞0.05）。结论：与活性维生素D相比，帕立骨化醇可以有效地降低iPTH，提高iPTH的达标率。同时，帕立骨化醇可降低高钙血症，钙磷乘积升高等不良反应的发生率。
[Abstract]:Objective: to evaluate the safety and efficacy of parathyroid alcohol in the treatment of secondary hyperparathyroidism in end-stage renal disease. Methods: the Pubmed database, Embase database, Wanfang database, Chongqing Weipu database, Chinese periodical full-text database were searched by computer, and the time was up to December 2013. A randomized controlled trial of parathyroid in the treatment of ESRD secondary hyperparathyroidism was performed with Rev Man5.2 software. Results: a total of 564 patients were included in 6 articles. The results showed that: the efficiency analysis showed that the iPTH reached the standard rate of parthenol group was higher than that of active vitamin D group. The decrease of iPTH in parietol group was greater than that in active vitamin D group, but there was no statistical significance [WMD-8.36 ~ 95CI-20.17 ~ 3.46 ~ 0.17]. Safety analysis: the incidence of hypercalcinemia in parthenol group was lower than that in active vitamin D group [RRX 0.4595%] (P < 0.0001). The increasing range of calcium and phosphorus product in parthenol group was less than that in active vitamin D group [WMD-0.0695]. The incidence of hyperphosphatemia, the changes of serum calcium and phosphorus in parietol group and active vitamin D group were similar (P > 0.05). Conclusion: compared with active vitamin D, parthenol can effectively reduce iPTH and improve the rate of iPTH. At the same time, parthenol reduced the incidence of adverse reactions such as hypercalcemia and increased calcium and phosphorus product.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692;R581.1

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