摘要
目的:探讨西那卡塞联合碳酸镧、骨化三醇治疗血液透析继发性甲状旁腺功能亢进(继发性甲旁亢)的效果。方法:选取2019年1月-2020年6月辽阳市第二人民医院收治的血液透析继发性甲旁亢患者80例,收集相关临床资料开展研究,依据用药治疗方案的差异分组,各40例。对照组应用碳酸镧联合骨化三醇治疗,研究组应用西那卡塞联合碳酸镧、骨化三醇治疗。对比两组疗效、甲状旁腺大小、血清中血磷、血钙、全段甲状旁腺激素(iPTH)水平及药物不良反应以及碱性磷酸酶(ALP)、血肌酐(Scr)、白蛋白(ALB)及尿素清除指数(Kt/V)水平。结果:研究组总有效率高于对照组(P<0.05);研究组治疗后甲状旁腺体积小于对照组,血磷、iPTH水平均低于对照组,血钙水平均高于对照组,差异均有统计学意义(P<0.05)。研究组不良反应发生率为22.5%,对照组为25.0%,两组比较差异无统计学意义(P>0.05);两组治疗前、治疗6个月后ALB、BUN、Scr、Kt/V水平比较,差异均无统计学意义(P>0.05)。结论:对血液透析继发甲旁亢患者施以西那卡塞联合碳酸镧、骨化三醇治疗方案干预,可促进临床治疗效果提升,还可调节血清中因子水平,减小甲状旁腺体积,且不会增加药物不良反应,不会影响患者残存的肾功能及透析的充分性,值得应用。
Objective:To explore and analyze the effect of Cinacalcet combined with Lanthanum Carbonate and Calcitriol in the treatment of hyperparathyroidism secondary to hemodialysis.Method:A total of 80 patients with Secondary hyperparathyroidism in Liaoyang Second People’s Hospital from January 2019 to June 2020 were selected,and the relevant clinical data were collected to carry out the research,and the patients were divided into groups according to the difference of drug treatment scheme,40 cases in each group.The control group was treated with Lanthanum Carbonate combined with Calcitriol,while the study group was treated with Cinacalcet combined with Lanthanum Carbonate and Calcitriol.The curative effect,parathyroid size,serum phosphorus,calcium,iPTH levels,adverse drug reactions,ALB,BUN,Scr and Kt/V levels were compared between two groups.Result:The total effective rate of the study group was higher than that of the control group (P<0.05);after treatment,the parathyroid volume was smaller than that of the control group,the levels of serum phosphorus and iPTH were lower than those in the control group,and the levels of serum calcium was higher than that in the control group,the differences were statistically significant (P<0.05).The total incidence of adverse reactions in the study group was 22.5%,and the control group was 25.0%,there was no significant difference between two groups (P>0.05).Before and 6 months after treatment,there were no significant differences in ALB,BUN,Scr and Kt/V levels between two groups (P>0.05).Conclusion:The intervention of Cinacalcet combined with Lanthanum Carbonate and Calcitriol in the treatment of patients with Secondary hyperparathyroidism can promote the clinical treatment effect,regulate the serum factor level,reduce the parathyroid volume,and will not increase the adverse drug reactions affect the residual renal function of patients and the adequacy of dialysis,which is worthy of application.
作者
段英杰
DUAN Yingjie(Liaoyang Second People’s Hospital,Liaoning Province,Liaoyang 111000,China)
出处
《中国医学创新》
CAS
2022年第6期6-10,共5页
Medical Innovation of China
关键词
西那卡塞
碳酸镧
骨化三醇
血液透析
继发性甲旁亢
Cinacalcet
Lanthanum Carbonate
Calcitriol
Hemodialysis
Secondary hyperparathyroidism
作者简介
通信作者:段英杰。
