静脉注射和口服活性维生素D_3治疗尿毒症性甲状旁腺功能亢进的多中心临床研究  

Effect of intravenous Calcijex on secondary uremic hyperparathyroidism: a multicenter clinical trial

作　　者：林善锬[1] 钱家麒[2] 汪关煜[3] 吴兆龙[4] 徐琴君[5] 唐令诠[6] 崔若兰[7] 冯菡芳[8] 梅长林[9] 

机构地区：[1]上海医科大学华山医院肾内科,200040 [2]上海第二医科大学仁济医院肾内科 [3]上海第二医科大学瑞金医院肾内科 [4]上海医科大学中山医院肾内科 [5]上海市第一人民医院肾内科 [6]上海市第六人民医院肾内科 [7]第二军医大学长海医院肾内科 [8]上海第二医科大学新华医院肾内科 [9]第二军医大学长征医院肾内科

出　　处：《上海医学》1999年第9期518-521,共4页Shanghai Medical Journal

摘　　要：目的　以口服活性维生素 Ｄ３（ 罗钙全） 冲击治疗为对照，观察和比较静脉注射活性维生素 Ｄ３（ 溉纯） 治疗尿毒症性甲状旁腺机能亢进（ 甲旁亢） 的有效性及安全性。方法　根据血浆完整甲状旁腺激素（ｉ Ｐ Ｔ Ｈ） 浓度，６４ 例患者分为轻、中、度重度甲旁亢组，３ 组再随机分为对照组和溉纯治疗组，分别给予２μｇ 、３μｇ 、４μｇ 罗钙全口服或溉纯静脉注射，观察治疗前后 Ｐ Ｔ Ｈ、 Ａ Ｋ Ｐ、钙和磷的变化。结果　治疗前对照组和溉纯组间的 Ｐ Ｔ Ｈ 水平差异无显著性；治疗后轻、中度甲旁亢组ｉ Ｐ Ｔ Ｈ 显著下降，两组下降程度差异无显著性；但对重度甲旁亢，溉纯抑制 Ｐ Ｔ Ｈ 分泌优于口服罗钙全组（ Ｐ＜０ ．０５） ，而高血钙副作用则低于后者。结论　溉纯治疗尿毒症继发性甲旁亢安全、有效，副作用小。与口服罗钙全冲击治疗比较，静脉注射溉纯更适于重度甲旁亢的治疗。Objective To observe the efficacy and safety of intravenous Calcijex on secondary uremic hyperparathyroidism (SPTH) compared with pulse oral rocaltrol. Methods 64 SHPT patients were classified into three groups, mild, moderate and severe, according to plasma intact PTH level; then each group was randomly divided into pulse oral rocaltrol and intravenous calcijex subgroups. Rocaltrol or Calcijex in the dosages of 2μg、3μg、4μg were given to mild, moderate and severe groups respectively. Changes in PTH, AKP, Ca 2+ and P 3- levels were observed before and after treatment. Results There was no significant difference in iPTH level between pulse oral rocaltrol and intravenous calcijex subgroups before treatment. After treatment, iPTH concentration in mild and moderate cases decreased remarkably; in severe cases, intravenous calcijex inhibited iPTH secretion stronger than pulse oral rocaltrol. Furthermore, hypercalcaemia caused by intravenous calciijex was less common than pulse oral calcijex. Conclusion Intravenous calcijex therapy for SHPT is safe, efficient and has less side effects. Compared with pulse oral rocaltrol, intravenous calcijex is more pertinent in treating severe SHPT case.(Shanghai Med J, 1999,22∶518 521)

关 键 词：尿毒症 甲状旁腺 机能亢进 维生素D3 

分 类 号：R695.06[医药卫生—泌尿科学] R582.105[医药卫生—外科学]