鲑鱼降钙素对维持性血液透析患者并发高钙血症的疗效观察  

Short-term efficacy of salmon calcitonin in maintenance hemodialysis patients with hypercalcaemia

作　　者：林炯程 梁萌[2] 许树根[2] 沈淑琼[2] 王赐玉[2] 

机构地区：[1]福建省厦门市海军鹭海医院内科,361001 [2]解放军174医院肾病中心

出　　处：《临床肾脏病杂志》2010年第4期160-162,共3页Journal Of Clinical Nephrology

摘　　要：目的观察鲑鱼降钙素治疗维持性血液透析（MHD）患者并发高钙血症的疗效。方法对28例MHD患者合并高钙血症者给予鲑鱼降钙素肌肉注射，开始每天1次，连续6d，以后每周2次，透析后使用。疗程12周。以用药前和用药后第2、4、8、12周检测血钙、血磷、钙磷乘积和血全段甲状旁腺素（iPTH）为指标，应用视觉模拟疼痛评分法对骨关节疼痛程度进行定量，并进行统计学分析。结果25例完成观察。治疗后第4周血钙、钙磷乘积均有不同程度降低，与治疗前比较有统计学意义（P〈0．05）；血磷和iPTH也有降低，但与治疗前比较差异无显著性。治疗后第4周，所有患者骨关节疼痛、活动障碍等症状均有不同程度缓解；疗程结束后23例症状基本消失，但治疗前已发生的转移性钙化等现象无变化。结论鲑鱼降钙素治疗MHD患者并发高钙血症，可以有效降低高血钙、钙磷乘积，并能够有效缓解骨关节疼痛症状，近期疗效显著。Objective To explore the short-term efficacy and safety of salmon calcitonin in maimenance hemodialysis （MHD） patients with hypercalcaemia. Methods Twenty-eight MHD patients with hy- percalcaernia were enrolled. Salmon calcitonin was intramuscularly injected once every day, for 6 days, then twice every week after dialysis. The total course was 12 weeks. The levels of serum calcium （Ca）, phosphorus （P） ,calciurrrphosphate product （Ca× p）, intact parathyroid hormone （iPTH） and visual analogue scale （VAS）of pain were assessed before and 2,4, 8and12 weeks after treatment. Results Twenty-five patients completed the observation. The serum Ca and CaX P at 4,8 and 12 weeks after treatment were significantly lower than the baseline level（P〈0. 05）. The serum P, and iPTH level after the treatment were slightly declined,but there was no significant difference in comparison to the baseline levels. At the same time, the patient＇s symptoms such as bone pain,joint dysfunction were significantly improved as compared with the baseline level. At the end of the experiment 23 patient＇s symptoms almost disappeared. No change happened on those patients with metastatic calcification. Few adverse events were found. Conclusions Salmon ealcitonin can decrease serum Ca, and Ca × P effectively and ease the bone pain symptoms in MHD patients with hypercalcaemia, and the short-term efficacy is satisfactory.

关 键 词：高钙血症 降钙素 肾透析 

分 类 号：R459.5[医药卫生—治疗学]