西那卡塞联合骨化三醇治疗血液透析患者继发性甲状旁腺功能亢进

发布时间：2018-02-11 21:35

本文关键词： 西那卡塞骨化三醇肾功能不全甲状旁腺功能亢进症继发性甲状旁腺素　出处：《中国新药与临床杂志》2016年09期 　论文类型：期刊论文

【摘要】：目的观察西那卡塞联合骨化三醇治疗血液透析患者继发性甲状旁腺功能亢进的临床疗效。方法血液透析致继发性甲状旁腺功能亢进患者120例,随机分为两组,每组60例。对照组给予骨化三醇治疗,初始剂量为0.25μg·d~(-1),每日1次,根据患者的耐受程度调整剂量最大至0.5μg·d~(-1),连续治疗3个月;观察组在骨化三醇治疗(同对照组)的同时联合西那卡塞治疗,初始剂量为25 mg·d~(-1),每日1次,根据患者的耐受程度调整剂量最大至50 mg·d~(-1),连续治疗3个月。比较两组的甲状旁腺大小、全段甲状旁腺激素(iPTH)水平、临床有效率、钙磷代谢以及残肾功能指标等。结果观察组完成58例,对照组完成57例。治疗后两组患者甲状旁腺的长、宽和厚及iPTH水平均显著下降(P0.05),且观察组下降水平更为明显(P0.05)。观察组总有效率为95%,高于对照组(67%,P0.05)。治疗后两组患者血钙水平上升,血磷、钙磷乘积下降(P0.05),且观察组上述3项指标变化程度均优于对照组(P0.05)。治疗后两组血肌酐、尿素氮、碱性磷酸酶和尿素清除指数均无明显变化(P0.05),且组间比较无显著差异(P0.05)。两组均无严重不良反应发生。结论西那卡塞联合骨化三醇治疗血液透析患者继发性甲状旁腺功能亢进的临床疗效好,能有效降低PTH水平,维持钙磷平衡,且患者残肾功能并无进一步恶化。
[Abstract]:Objective To observe the clinical effect of cinacalcet combined with ossification in three alcohol treatment of blood dialysis patients with secondary hyperparathyroidism. 120 cases of patients with secondary hyperparathyroidism caused by hemodialysis methods, were randomly divided into two groups, 60 cases in each group. The control group was given ossification in three alcohol treatment, the initial dose was 0.25 G - d~ (-1) and 1 times a day, according to the tolerance of patients to adjust the dose to a maximum of 0.5 g - d~ (-1), 3 consecutive months of treatment; the observation group in the treatment of ossification in three alcohol (as control group) combined with cinacalcet treatment, the initial dose was 25 mg - d~ (-1), 1 times a day. According to the tolerance dose adjustment in patients with up to 50 mg - d~ (-1), continuous treatment for 3 months. Compared with two groups of parathyroid size, intact parathyroid hormone (iPTH) levels, clinical efficiency, calcium and phosphorus metabolism and residual renal function indexes. Results the observation group 58 cases, control group 57 cases. Two groups of patients after treatment of parathyroid glands, wide and thick and iPTH levels were significantly decreased (P0.05), and the observation group decreased more obvious level (P0.05). The total effective rate of observation group was 95%, higher than the control group (67%, P0.05). Increased serum calcium levels in the two groups after treatment of serum phosphorus, calcium phosphorus product decreased (P0.05), and the observation group of the 3 indicators of changes were better than the control group (P0.05). After treatment, two groups of serum creatinine, urea nitrogen, alkaline phosphatase and urea clearance index showed no significant change (P0.05), and no significant difference between groups (P0.05). No serious adverse reactions in both two groups. Conclusion the curative effect of cinacalcet combined with ossification in three alcohol treatment of blood dialysis patients with secondary hyperparathyroidism, can effectively reduce the PTH level, maintaining calcium and phosphorus balance, and residual renal function in patients with no further deterioration.

【作者单位】：长治医学院附属和济医院肾内科;
【分类号】：R692.5;R582.1

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