摘要
目的:探究西那卡塞与小剂量骨化三醇联合治疗维持性血液透析(MHD)合并重度继发性甲状旁腺功能亢进(SHPT)的效果。方法:选取2016年1月-2018年7月本院收治的MHD合并重度SHPT患者60例。采用掷硬币法将60例患者分为观察组和对照组,各30例。对照组给予西那卡塞治疗,观察组在对照组基础上给予小剂量骨化三醇治疗。比较两组临床症状、血清因子(Ca、P、ALP、iPTH)、甲状旁腺体积及生活质量情况。结果:治疗3个月后,观察组骨痛或关节痛、失眠症状改善均明显优于对照组(P<0.05);观察组甲状旁腺体积小于对照组(P<0.05);观察组血清P、ALP及iPTH水平均低于对照组(P<0.05),但观察组治疗前后血清Ca水平比较,差异无统计学意义(P>0.05);观察组SF-36量表各维度评分均高于对照组(P<0.05)。结论:西那卡塞与小剂量骨化三醇联合治疗可调节MHD合并重度SHPT患者体内钙磷代谢及iPTH水平,对缓解临床症状及提高生活质量有重要帮助。
Objective:To investigate the effect of Cinacalcet combined with low-dose Calcitriol on maintenance hemodialysis(MHD)and severe secondary hyperparathyroidism(SHPT).Method:A total of60 patients with MHD and severe SHPT admitted to our hospital from January 2016 to July 2018 were selected.According to coin tossing method,they were randomly divided into observation group and control group,30 cases in each group.The control group was treated with Cinacalcet,while observation group was treated with low-dose Calcitriol on the basis of control group.The clinical symptoms,serum factors(Ca,P,ALP,iPTH),parathyroid volume and quality of life between two groups were compared.Result:After 3 months of treatment,the symptoms of bone pain,joint pain and insomnia in observation group were significantly better than those of control group(P<0.05).The volume of parathyroid gland in observation group was smaller than that of control group(P<0.05).The levels of serum P,ALP and iPTH in observation group were lower than those of control group(P<0.05),but the serum Ca level in observation group before and after treatment was compared,the difference was not statistically significant(P>0.05).The each score of SF-36 scale in observation group were higher than those of control group(P<0.05).Conclusion:Cinacalcet combined with low-dose Calcitriol can regulate calcium and phosphorus metabolism and iPTH level in patients with MHD and severe SHPT,which is helpful to relieve clinical symptoms and improve quality of life.
作者
梁翔
邹原方
LIANG Xiang;ZOU Yuanfang(Dongguan Tungwah Hospital,Dongguan 523000,China)
出处
《中国医学创新》
CAS
2019年第15期51-55,共5页
Medical Innovation of China
关键词
维持性血液透析
甲状旁腺功能亢进
西那卡塞
骨化三醇
钙磷代谢
Maintenance hemodialysis
Hyperparathyroidism
Cinacalcet
Calcitriol
Calcium and phosphorus metabolism
作者简介
通信作者:梁翔.
