短期用西那卡塞对继发性甲状旁腺功能亢进症的血透患者血成纤维细胞生长因子23、血骨保护素的影响研究  

Effects of Short-term Using of Cinacalcet on Hematopoietic Fibroblast Growth Factor 23 and Blood Osteoprotegerin in Hemodialysis Patients with Secondary Hyperparathyroidism

作　　者：靳政玺[1] 张菁[1] 王红梅[1] 陈强[1] 

机构地区：[1]南京医科大学附属苏州医院肾内科,江苏苏州215008

出　　处：《华南国防医学杂志》2017年第6期372-375,共4页Military Medical Journal of South China

基　　金：南京医科大学科技发展基金项目(2015 NJMU129)

摘　　要：目的研究短期使用盐酸西那卡塞治疗尿毒症并发继发性甲状旁腺功能亢进症(secondary hyperparathyroidism,SHPT)的长期血透患者的高磷、高钙、高血清全段甲状旁腺激素(intact parathyroid hormone,iPTH)及对血高成纤维细胞生长因子23(fibroblast growth factor-23,FGF-23)、血骨保护素(osteoprotegerin,OPG)的影响。方法选取作者医院血透中心长期行血液透析并发SHPT的患者20例(血钙>2.75 mmol/L,钙磷乘积>4.52 mmol^2/L^2)为研究对象。根据患者血磷、血钙、iPTH水平予以相应口服剂量西那卡塞,疗程4周。4周后停用西那卡塞,检测并分析血磷、血钙、血iPTH、血清FGF-23、血OPG。结果 20名患者均完成全部观察,经西那卡塞治疗4周后,血磷、血钙、血iPTH、血OPG、血FGF-23水平较西那卡塞使用前均减少,且有统计学差异(P<0.01)。血红蛋白(hemoglobin,HGB)、血清白蛋白(albumin,ALB)使用西那卡塞前后变化无统计学差异(P>0.05)。结论西那卡塞可有效纠正慢性肾衰竭患者并发SHPT的高磷、高钙、高iPTH,短期内应用可降低患者血磷、血钙、iPTH、FGF-23、血OPG水平。西那卡塞易出现恶心、呕吐、低钙等不良反映,宜短期服用。Objective To investigate the influence of short-term using of cinaealcet hydrochloride on high serum phosph~ blood calcium, intact parathyroid hormone （iPTH）, blood fihroblast growth factor-23 （FGF-23） and blood osteoprotegerin （OPG） of chronic hemodialysis patients complicated with secondary hyperparathyroidism （SHPT）. Methods Twenty chronic hemodialysis patients complicated with SHPT （blood calcium〉2. 75 mmol/L, calcium-phos- phorus product〉4. 52 mmol2/L2 ） in hemodialysis center of authors＇ hospital were analyzed. The serum phosphorus, blood calcium, iPTH, FGF-23, blood OPG were observed after 4 weeks treatment with cinacalcet. Results After 4 weeks treatment with cinacalcet, the levels of serum phosphorus, blood calcium, iPTH, FGF-23, blood OPG were lower than those before the cinacalcet treatment of all 20 patients. The hemoglobin, albumin had no changes before and after the treatment of cinacalcet. Conclusion Short-term using of cinacalcet can effectively correct serum phosphorus, blood calci- um, iPTH, FGF-23, blood OPG for chronic renal failure patients complicated with SHPT. Cinacalcet can cause nausea, vomiting, low calcium, other adverse reactions, and it is appropriate to short-term use.

关 键 词：西那卡塞 慢性肾衰竭 继发性甲状旁腺功能亢进症 血高成纤维细胞生长因子23 血骨保护素 

分 类 号：R459.5[医药卫生—治疗学] R582.1[医药卫生—临床医学]