碳酸镧联合阿法骨化醇治疗维持性腹膜透析患者继发甲状旁腺功能亢进的临床效果观察  

Clinical effect observation of lanthanum carbonate combined with alphacalcidol in the treatment of continuous peritoneal dialysis patients with secondary hyperparathyroidism

作　　者：吴静[1] 宋新灵[2] 杨霞[1] 陈爽[1] 冉燕[1] 査艳 

机构地区：[1]贵州省人民医院肾内科,贵阳550002 [2]贵州省人民医院内科,贵阳550002

出　　处：《中国当代医药》2014年第23期96-98,共3页China Modern Medicine

基　　金：贵州省科技厅-省人民医院联合基金项目(黔科合LS字[2012]037号);贵州省卫生厅科学技术基金项目(黔科合J字[2012]2173号);贵州省省长基金[黔省专合字(2012)128号];贵州省优秀青年科技人才培养对象专项资金[黔科合人字(2013)43号]

摘　　要：目的观察碳酸镧联合阿法骨化醇治疗维持性腹膜透析患者继发甲状旁腺功能亢进的效果。方法选取30例维持性非卧床腹膜透析继发甲状旁腺功能亢进患者,随机分为对照组(n=15,阿法骨化醇0.5μg/d)和治疗组(n=15,阿法骨化醇0.5μg、1次/d+碳酸镧500 mg、3次/d),观察治疗前及治疗后连续3个月的血Ca2+、血P3+及血全段甲状旁腺激素(iPTH)水平变化。结果对照组治疗2、3个月后,仅血Ca2+有明显改善(P<0.05),血P3+、血iPTH与治疗前比较差异无统计学意义(P>0.05)。治疗组的血P3+于治疗后1个月开始下降,血Ca2+、血iPTH于治疗后2个月开始有显著改善(P<0.05);与对照组治疗3个月相比,治疗组血P3+、血iPTH改善明显,差异有统计学意义(P<0.05)。结论在阿法骨化醇基础上加用碳酸镧可明显改善维持性腹膜透析患者钙磷代谢紊乱,有效缓解继发甲状旁腺功能亢进。Objective To observe the effect of lanthanum carbonate combined with alphacalcidol in the treatment of continuous peritoneal dialysis patients with secondary hyperparathyroidism. Methods 30 cases of continuous ambulatory peritoneal dialysis patients with secondary hyperparathyroidism were selected and randomly divided into control group （n=15,alphacalcidol 0.5 μg/d）and treatment group （n=15,alphacalcidol 0.5 μg/d＋lanthanum carbonate 500 mg,three times a day）.In 3 months of treatment,serum calcium （Ca^2＋）,serum phosphate （P^3＋）and serum intact parathyroid hormone （iPTH）was observed respectively. Results After 2 and 3 months of treatment in control group,only the level of serum Ca^2＋increased obviously between before and after treatment,with statistical difference （P〈0.05）.There was no statistical difference in the change of serum P^3＋and iPTH （P〉0.05）in control group.In treatment group,serum P^3＋began to fall evidently after 1 month of combination therapy with lanthanum carbonate（P〈0.05）.Serum Ca^2＋and iPTH showed significant change after 2 month of treatment（P〈0.05）.There was statistical difference on the serum P^3＋and iPTH between treatment group and control group after 3 months respectively（P〈0.05）. Conclusion Alphacalcidol combined lanthanum carbonate can obviously improve the calcium and phosphorus metabolism disorder in peritoneal dialysis patients,and relieve secondary hyperparathyroidism effectively.

关 键 词：阿法骨化醇 碳酸镧 维持性腹膜透析 甲状旁腺功能亢进 

分 类 号：R459.5[医药卫生—治疗学]