常规和冲击剂量的阿法D_3治疗尿毒症继发性甲状旁腺功能亢进  

ROUTINE AND PULSE DOSAGE ALPHA D_3 THERAPY FOR UREMIA PATIENTS WITH SECONDARY HYPERPARATHYROIDISM

作　　者：刘碧华 曹治涵[1] 周巧玲[1] 

机构地区：[1]中南大学湘雅医院肾内科

出　　处：《中国现代医学杂志》2002年第5期35-37,共3页China Journal of Modern Medicine

基　　金：湖南省卫生厅中标课题 ( 96 2 4 )

摘　　要：目的 :对照观察常规和冲击剂量的阿法D3对尿毒症继发性甲状旁腺功能亢进 (SHPT)的疗效。方法 :33例尿毒症维持血透患者 ,随机分为常规治疗组 (n =1 4口服阿法D30 .2 5μg/d× 1 2周 )和冲击治疗组 (n =1 9口服阿法D32 μg/次 ,每周 2次× 1 2周 )。治疗前、后分别测定患者血羧基端甲状旁腺激素 (C -PTH)、血钙、血磷、BUN、Scr和ALT。结果 :治疗后 ,血C -PTH均明显下降 (P <0 .0 1 ) ,冲击组下降更显著 (P <0 .0 1 )。血钙显著上升 (P <0 .0 1 )。血磷、BUN、Scr和ALT无明显变化。结论 :常规和冲击剂量阿法D3治疗尿毒症SHPT ,均能有效地降低血C -PTH ,升高血钙 ,对血磷 ,肝肾功能无明显影响 ,且冲击疗法优于常规疗法。Objective:To compare the therapeutic effects of routine and pulse dosage alpha D 3 on uremia patients with secondary hyperparathyroidism(SHPT) . Methods:Thirty-three uremia patients with maintenance hemodialysis were randomly divided into two groups: 14 patients in the routine therapy group (oral alpha D 3,0.25μg/d for 12 weeks) and 19 patients in the pulse therapy group (oral alpha D 3,2μg/time, twice a week of 12 weeks). Seurm C-PTH,calcium,phosphate,BUN,Scr and ALT were measured before and after the treatment. Results:1. Serum C-PTH decreased significantly( P <0.01) in the two therapy groups following treatment, and the decrease was more significant( P <0.01) in the pulse group than in the routine group. 2. Serum calcium increased significantly( P <0.01) and serum phosphate, BUN,Scr and ALT did not alter after treatment in the two therapy groups.Conclusions:Routine and pulse dosage therapy can effectively decrease serum C-PTH and elevate serum calcium without significant influence on serum phosphate and the liver and renal functions in the uremia patients with SHPT.The pulse dosage therapy is superior to the routine therapy.

关 键 词：甲状旁腺激素 尿毒症 阿法D3 治疗 继发性甲状旁腺功能亢进 

分 类 号：R582.1[医药卫生—内分泌] R692.5[医药卫生—内科学]