摘要
目的分析碳酸司维拉姆对慢性肾功能衰竭(慢性肾衰竭)合并高磷血症患者肾功能、血脂及微炎症的影响。方法采用计算机随机数字表法将117例慢性肾衰竭合并高磷血症患者分为基础组与治疗组,基础组(58例)接受常规治疗,治疗组(59例)在基础组治疗的基础上给予碳酸司维拉姆。比较2组患者的血磷、血钙、肾功能、血脂、微炎症因子水平、临床疗效和不良反应。结果治疗前2组患者血磷、血钙和钙磷乘积水平比较差异无统计学意义(P>0.05),治疗后2组血磷及钙磷乘积水平均降低,且治疗组低于基础组,差异有统计学意义(P<0.05)。治疗前2组患者血清肌酐(SCr)、血清尿素氮(BUN)和内生肌酐清除率(CCr)水平比较差异无统计学意义(P>0.05),治疗后2组SCr、BUN水平较治疗前均降低,CCr水平较治疗前升高,且治疗组SCr、BUN水平低于基础组,CCr水平高于基础组,差异有统计学意义(P<0.05)。治疗前2组患者总胆固醇(TC)、低密度脂蛋白胆固醇(LDL)、高密度脂蛋白胆固醇(HDL-C)水平比较差异无统计学意义(P>0.05);治疗后2组血脂水平均改善,且治疗组患者TC、LDL水平低于基础组,HDL-C水平高于基础组,差异均有统计学意义(P<0.05)。治疗前2组患者C-反应蛋白(CRP)、白细胞介素-6(IL-6)水平比较差异无统计学意义(P>0.05),治疗后2组CRP和IL-6均降低,且治疗组CRP和IL-6低于基础组,差异有统计学意义(P<0.05)。治疗组临床总有效率高于基础组(88.1%vs 72.4%,P<0.05)。治疗组患者不良反应发生率低于基础组,差异有统计学意义(P<0.05)。结论碳酸司维拉姆可改善慢性肾衰竭合并高磷血症患者的肾功能、血脂和微炎症反应,具有较好的临床效果。
Objective To investigate the effects of sevelamer carbonate on renal function,blood lipid and microinflammation in patients with chronic renal failure complicating hyperphosphatemia.Methods A total of 117 patients with chronic renal failure complicating hyperphosphatemia were divided into 2 groups by random number table methods.The basic group(n=58)received routine treatment,while the treatment group(n=59)received routine treatment combined with sevelamer carbonate.Then the serum phosphorus and calcium,renal function,blood lipid,microinflammatory factors,clinical efficacy and adverse reactions were compared between the 2 groups.Results The serum phosphorus,serum calcium and calcium-phosphorus product showed no significant difference between the 2 groups at the baseline(P>0.05),and the levels of 3 indicators were decreased in both groups after treatment,which were lower in treatment group than in basic group,the difference was statistically significant(P<0.05).The levels of serum creatinine(SCr),blood urea nitrogen(BUN)and creatinine clearance(Ccr)demonstrated no significant difference between the 2 groups at the baseline(P>0.05).After treatment,a decrease in serum levels of SCr and BUN along with an increase in serum CCr were found in both groups.Meanwhile,the treatment group had significantly lower SCr and BUN levels and higher CCr level than those of basic group(P<0.05).The adverse reaction rate of treatment group was lower than that of basic group,the difference was statistically significant(P<0.05).The levels of total cholesterol(TC),low-density lipoprotein(LDL)and high-density lipoprotein cholesterol(HDL-C)yielded no significant difference between the 2 groups at the baseline(P>0.05).After treatment,the above blood lipid indicators were significantly improved in both groups,and the treatment group had significant difference TC level as well as lower LDL and HDL-C levels than basic group(P<0.05).There was no significant difference in the levels of C-reactive protein(CRP)and interleukin-6(IL-6)between the 2 groups before treatment(P<0.05).After treatment,CRP and IL-6 decreased in the 2 groups,and CRP and IL-6 in the treatment group were lower than those in the basic group(P<0.05).The total clinical effective rate in the treatment group was higher than that in the basic group(88.1%vs 72.4%,P<0.05).The incidence of adverse reactions in the treatment group was significantly lower than that in the basic group(P<0.05).Conclusion Application of sevelamer carbonate can effectively ameliorate the renal function,blood lipid and microinflammation in patients with chronic renal failure complicating hyperphosphatemia,which is worthy of recommendation.
作者
杨艳艳
赵燕
吕治安
赵莉
许俊
黎宝玲
李侠
程丽荣
YANG Yanyan;ZHAO Yan;Lü Zhian;ZHAO Li;XU Jun;LI Baoling;LI Xia;CHENG Lirong(Department of Nephrology,the Second Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710004,China;Department of Nephrology,Xi′an Central Hospital,Xi′an 710003,China)
出处
《西北药学杂志》
CAS
2021年第6期975-979,共5页
Northwest Pharmaceutical Journal
基金
陕西省社会发展科技攻关项目(编号:2016SF-224)。
关键词
碳酸司维拉姆
慢性肾功能衰竭
高磷血症
肾功能
血脂
微炎症
不良反应
sevelamer carbonate
chronic renal failure
hyperphosphatemia
renal function
blood lipids
microinflammation
adverse reactions
作者简介
杨艳艳,女,医师;通信作者:吕治安,男,主治医师。
