地舒单抗对维持性血液透析患者血钙和骨转换指标的影响  

Changes of serum calcium and bone turnover markers in maintenance hemodialysis patients treated with denosumab

作　　者：王琰[1] 朱丽 杨冰[1] 甘良英 左力[1] Wang Yan;Zhu Li;Yang Bing;Gan Liangying;Zuo Li(Department of Nephrology,Peking University People′s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院肾内科,北京100044

出　　处：《中华医学杂志》2023年第8期594-597,共4页National Medical Journal of China

基　　金：北京市科学技术委员会首都临床特色应用研究项目(Z131107002213122)

摘　　要：选取2021年7至12月在北京大学人民医院规律血液透析且存在骨量减少或骨质疏松的患者共20例(男8例,女12例),年龄(64.8±13.9)岁,给予地舒单抗60 mg皮下注射。患者血钙在用药1个月时平均降低0.31 mmol/L,此时40%(8/20)的患者血清校正钙<2.1 mmol/L。患者骨转换指标在用药3 d后即出现下降,并持续降低至用药后5个月。多因素logistic回归分析未发现低钙血症相关的独立危险因素(R^(2)=0.516,P=0.021)。可见,地舒单抗能明显降低血液透析患者的骨转换速率,但用药后更易发生低钙血症。A total of 20 patients(8 males and 12 females)aged(64.8±13.9)years who underwent regular hemodialysis and had bone loss or osteoporosis in Peking University People′s Hospital from July to December 2021 were recruited.Sixty milligrams of denosumab were given subcutaneously.The average serum calcium decreased by 0.31 mmol/L and 40%(8/20)of the patients had hypocalcemia one month after treatment.The markers of bone turnover began to decrease 3 days after treatment,and continued to decrease until 5 months after denosumab medication.Multivariate logistic regression analysis failed to detect any independent risk factor for hypocalcemia(R^(2)=0.516,P=0.021).Therefore,denosumab can significantly inhibit bone turnover in hemodialysis patients,however,patients with denosumab medication are more prone to hypocalcemia.

关 键 词：肾透析 低钙血症 RANK配体 地舒单抗 

分 类 号：R692.5[医药卫生—泌尿科学]