阿法骨化醇对维持性血液透析患者甲状旁腺激素的影响及临床意义  

Clinical significance and influence of alfacalcidol on intact parathyroid hormone in maintenance hemodialysis patients

作　　者：王东辉[1] 杜娟[2] 高寒[2] 胡曼丽[1] 田小海[1] 

机构地区：[1]长春医学高等专科学校,130031 [2]长春市中心医院肾病科

出　　处：《中国实用医药》2015年第3期4-5,共2页China Practical Medicine

基　　金：吉林省教育厅"十一五"科学技术研究(项目编号:吉教科合字2008第433号)

摘　　要：目的观察阿法骨化醇对维持性血液透析患者甲状旁腺激素(iPTH)的影响,并探讨其临床意义。方法 24例慢性肾衰竭尿毒症期行维持性血液透析治疗6个月以上患者作为血液透析组(HD组),同期体检健康人群22例作为健康对照组(Con组)。治疗开始HD组患者口服阿法骨化醇,1μg/d,元素钙2000 mg。共观察12周。Con组患者及HD组患者用药前后均查肾功能及血电解质,用放免法检测iPTH和骨钙素(BGP)。结果用药前HD组与Con组比较,iPTH,BGP及血肌酐(Cre)明显升高,血钙(Ca)降低,血磷(P)升高,差异有统计学意义(P<0.05)。用药后HD组iPTH和BGP明显下降,血钙升高,差异有统计学意义(P<0.05)。结论补充阿法骨化醇,可以降低维持性血液透析患者血清iPTH水平,进而改善肾性骨病,为临床治疗提供了新思路。Objective To observe the influence of alfacalcidol on intact parathyroid hormone （iPTH） in maintenance hemodialysis patients, and to investigate its clinical significance.Methods Hemodialysis group （HD group） contained 24 patients with maintenance hemodialysis of chronic renal failure uremia for more than 6 months, and health control group （Con group） contained 22 health people in the same time period. HD group received 1μg/d of alfacalcidol and 2000 mg of calcium through oral administration. The observation lasted for 12 weeks. The renal function and blood electrolytes were detected in the two groups before and after treatment. Intact parathyroid hormone and bone gla protein （BGP） were detected by radioimmunoassay method.Results HD group had higher iPTH, BGP and serum creatinine （Cre）, decreased blood calcium （Ca）, and increased serum phosphate （P） than the Con group before treatment. The difference had statistical significance （P〈0.05）. The iPTH and BGP decreased and blood calcium increased in HG group after treatment, and the difference had statistical significance （P〈0.05）.Conclusion Supplement of alfacalcidol can reduce iPTH level in maintenance hemodialysis patients, therefore their renal osteopathy can be improved. This method provides a new idea for clinical treatment.

关 键 词：阿法骨化醇 全段甲状旁腺激素 维持性血液透析 

分 类 号：R459.5[医药卫生—治疗学]