碳酸镧治疗尿毒症维持性血液透析患者高磷血症的临床观察

发布时间：2018-07-22 14:18

【摘要】：目的:观察碳酸镧治疗尿毒症维持性血液透析患者高磷血症的临床疗效及安全性。方法:选取2012年1月-2016年12月第三军医大学新桥医院和重庆市巴南区中医院的尿毒症维持性血液透析并发高磷血症患者142例,均给予嚼服碳酸镧咀嚼片治疗,起始剂量:血磷为1.78~2.26 mmol/L时,250 mg,tid;血磷2.26 mmol/L时,500 mg,tid。在治疗过程中,根据患者血磷水平调整药物剂量。治疗1、2、3个月后,检测患者血磷、血钙、白蛋白、甲状旁腺激素(PTH)和碱性磷酸酶水平,计算校正血钙及钙磷乘积,并观察不良反应。结果:治疗1、2、3个月后,所有患者血磷、钙磷乘积水平均较治疗前显著下降,差异有统计学意义(P0.05);治疗3个月后,血钙校正浓度较治疗前显著减低,差异有统计学意义(P0.05);治疗前后,患者血浆白蛋白、碱性磷酸酶、PTH水平比较,差异无统计学意义(P0.05)。患者总有效率为93.7%。有19例患者出现轻微不良反应。结论:碳酸镧治疗尿毒症维持性血液透析患者高磷血症具有较高的临床有效率,能明显降低患者血磷和钙磷乘积,且安全性较好。
[Abstract]:Objective: to observe the efficacy and safety of lanthanum carbonate in the treatment of hyperphosphatemia in patients with uremia maintenance hemodialysis. Methods: 142 patients with uremia maintenance hemodialysis complicated with hyperphosphatemia were selected from Xinqiao Hospital of the third military Medical University and Banan Hospital of traditional Chinese Medicine from January 2012 to December 2016. All patients were treated with lanthanum carbonate chewable tablets. The initial dose of plasma phosphorus was 1.78 ~ 2.26 mmol 路L ~ (-1) and that of blood phosphorus was 2.26 mmol / L and 500 mg 路L ~ (-1) 路L ~ (-1) 路L ~ (-1) 路L ~ (-1) 路L ~ (-1) ~ (-1). During the course of treatment, the dosage of the drug was adjusted according to the blood phosphorus level of the patient. The levels of serum phosphorus, serum calcium, albumin, parathyroid hormone (PTH) and alkaline phosphatase (ALP) were measured after treatment for 1 and 3 months. The corrected blood calcium and calcium phosphorus products were calculated and the adverse reactions were observed. Results: after 1 and 3 months of treatment, the levels of serum phosphorus, calcium and phosphorus product in all patients were significantly lower than those before treatment (P0.05), and the corrected serum calcium concentration was significantly lower after 3 months of treatment than that before treatment. The difference was statistically significant (P0.05); before and after treatment, there was no significant difference in plasma albumin and alkaline phosphatase PTH levels (P0.05). The total effective rate was 93. 7%. There were 19 patients with mild adverse reactions. Conclusion: lanthanum carbonate has a high clinical effective rate in the treatment of hyperphosphatemia in patients with uremia maintenance hemodialysis. It can obviously reduce the product of phosphorus and calcium and phosphorus in patients with uremia, and the safety is good.
【作者单位】：重庆市巴南区中医院内二科;第三军医大学新桥医院肾内科;
【基金】：国家自然科学基金资助项目(No.81400747)
【分类号】：R692.5

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