摘要
目的分析西那卡塞联合活性维生素D(骨化三醇胶丸)对血透继发性甲状旁腺功能亢进(secondary hyperparathyroidism,SHPT)患者钙磷及甲状旁腺激素水平的影响。方法选择2019年5月-2021年5月血透SHPT患者96例,采用随机数字表法分为观察组(48例)和对照组(48例)。两组患者(存在高磷血症者)口服碳酸钙或碳酸镧降磷治疗,对照组每次透析后当晚服用骨化三醇胶丸;观察组患者在骨化三醇胶丸的基础上增加盐酸西那卡塞片。治疗6个月后,检测患者尿素氮(blood urea nitrogen,BUN)、血肌酐(serum creatinine,Scr)、血钙、血磷及全段甲状旁腺激素(immunoreactive parathyroid hormone,iPTH)的含量;并分析患者的治疗效果及记录不良反应发生情况。结果观察组患者治疗有效率为89.58%,高于对照组的72.92%(P<0.05)。治疗前两组患者的血钙、血磷、iPTH、Scr、BUN水平及尿素清除率差异无统计学意义(P均>0.05);治疗后观察组患者血钙[(2.09±0.13)mmol/L]、血磷[(1.17±0.09)mmol/L]、iPTH[(213.22±30.58)ng/L]低于对照组血钙[(2.31±0.11)mmol/L]、血磷[(1.63±0.08)mmol/L]、iPTH[(296.31±28.19)ng/L](P均<0.05);但两组患者的BUN、Scr水平及尿素清除率差异无统计学意义(P均>0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论西那卡塞联合骨化三醇胶丸能改善透析SHPT患者的钙磷指标,提高患者的临床治疗效果。
Objective To analyze the effect of cinacarbose combined with active vitamin D on calcium,phosphorus and parathyroid hormone levels in patients with secondary hyperparathyroidism after hemodialysis.Methods A total of 96 patients with secondary hyperparathyroidism from May 2019 to may 2021 were randomly divided into observation group and control group(48 cases for each).The patients in the two groups(with hyperphosphatemia)were treated with calcium carbonate or lanthanum carbonate.The patients in the control group were treated with active vitamin D(calcitriol capsules)in the evening after each dialysis,while the patients in the observation group were added with cinacarbose hydrochloride tablets on the basis of calcitriol.After 6 months of the treatment,the levels of urea nitrogen,creatinine,calcium,phosphorus and parathyroid hormone were detected,and the treatment effect and adverse reactions were recorded.Results The effective rate of the observation group was 89.58%,which was significantly higher than 72.92%of the control group(P<0.05).Before the treatment,there was no significant difference in serum calcium,phosphorus,iPTH,SCR,BUN levels and urea clearance rate(P>0.05).After the treatment,in the observation group,the blood calcium was(2.09±0.13)mmol/L,blood phosphorus was(1.17±0.09)mmol/L and iPTH was(213.22±30.58)ng/L,which were significantly lower than those in the control group:blood calcium was(2.31±0.11)mmol/L,blood phosphorus was(1.63±0.08)mmol/L and iPTH was(296.31±28.19)ng/L(P<0.05);but there were no significant differences in bun,SCR levels and urea clearance rate between the two groups(P>0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Cinacarbose combined with active vitamin D can improve the calcium and phosphorus index of patients with dialysis secondary hyperparathyroidism,and improve the clinical treatment effect of patients.
作者
谈雅吟
高潮清
郑凤云
刘勇
TAN Yayin;GAO Chaoqing;ZHENG Fengyun;LIU Yong(Blood Purification Center,Yijishan Hospital,Wannan Medical College,Anhui Wuhu 241000,China)
出处
《新疆医科大学学报》
CAS
2021年第6期702-705,共4页
Journal of Xinjiang Medical University
基金
安徽医药科研计划课题项目(198XJ201927S9)
芜湖市科技计划项目(2020rkx4-4)。
作者简介
谈雅吟(1982-),女,硕士,主治医生,研究方向:血液净化,E-mail:48484643@qq.com。
