骨化三醇治疗慢性肾脏病患者继发性甲状旁腺功能亢进的临床疗效  

Treatment of ROD for CKD patients with calcitriol

作　　者：张澎[1] 郭秋花[1] 李彬[1] 

机构地区：[1]宁夏银川市第一人民医院,宁夏银川750001

出　　处：《宁夏医学杂志》2007年第12期1082-1083,共2页Ningxia Medical Journal

摘　　要：目的探讨骨化三醇治疗慢性肾脏病的非透析患者继发性甲状旁腺功能亢进的疗效。方法根据血清全段甲状旁腺激素(iPTH)水平选择尚未进入替代治疗的慢性肾脏病(CKD4,5)患者32例,根据血iIPTH的水平确定骨化三醇〔1,25(OH)2D3〕的治疗剂量,比较治疗前及治疗后4、8周的iPTH、血钙及磷的变化及临床症状的缓解程度。结果(1)32例患者治疗前血清iPTH为(517.28±275.24)pg/m l,经治疗8周后iPTH总达标率93.8%;(2)治疗中患者的血钙及磷的水平均有升高,高钙血症发生率18.8%;(3)临床症状有不同改善,症状缓解较明显者占68.7%。结论1,25(OH)2D3口服治疗慢性肾脏病(CKD4,5期)合并继发性甲状旁腺功能亢进(SHPT)的非透析患者疗效显著,临床症状改善明显。Objective To explore the therapy of 1,25 （OH） 2 D3 in treating secondary hyperparathyroidism （SHPT） in maintenance non -hemodialysis Patients. Methods We can choose CKD patients who haven,t entered alternative therapy yet with elevated intact parathyroid hormone ,the therapeutic dosage of 1,25（OH）2D3 was determined by the serum level of pretherapeutic iPTH , serum concentration of iPTH ,calcium and phosphorus and the remission degree of clinical symptoms were tested before and at the 4th 8th week after 1,25 （OH） 2 D3 treatment. Results （ 1 ） The serum level of pretherapeutic iPTH is 517.28± 275.24 pg/ml, After therapy for eight weeks , 93.8% of patients reached target. （2） Both serum calcium and phosphorus concentration were elevated in therapy, But the incidence rate of hypercalcemia is 18.8%. （3） The remission rate of clinical symptoms reached 96.9%. Condusion Oral 1,25 （OH） 2D3 is highly efficacious for the treatment of secondary hyperparathy roidism（SHPT） in maintenance non - hemodialysis patients.

关 键 词：1 25(OH)2D3 慢性肾脏病 肾性骨病 继发性甲状旁腺功能亢进 甲状旁腺激素 

分 类 号：R692.5[医药卫生—泌尿科学]