阿法骨化醇联合血液灌流与血液透析对慢性肾脏病-矿物质和骨异常患者钙磷代谢的影响  

Effect of Alfacalciferol Combined with Hemoperfusion and Hemodialysis on Calcium and Phosphorus Metabolism in Patients with Chronic Kidney Disease-Minerals and Bone Abnormalities

作　　者：张善宝[1] 曲晓璐[1] 漆映辉[1] 杜美莲 Zhang Shanbao;Qu Xiaolu;Qi Yinghui;Du Meilian(Department of Nephrology,Shanghai Punan Hospital of Pudong New District,Shanghai,China 200125)

机构地区：[1]上海市浦东新区浦南医院肾病内科,上海200125

出　　处：《中国药业》2018年第19期63-65,共3页China Pharmaceuticals

基　　金：上海市浦东新区科技发展基金[PKJ2016-Y05]

摘　　要：目的探讨阿法骨化醇联合血液灌流与血液透析对慢性肾脏病-矿物质和骨异常(CKD-MBD)患者钙磷代谢的影响。方法选取医院2014年12月至2017年1月收治的CKD-MBD患者104例,采用回顾性分析法,根据治疗方式的不同分为对照组(50例)和观察组(54例)。对照组患者予以血液灌流和血液透析等CKD-MBD临床对症治疗,观察组患者在对照组患者治疗基础上加用阿法骨化醇治疗,均治疗12周。结果两组患者治疗前全段甲状旁腺激素(iPTH)、血钙(Ca)、血磷(P)水平比较无差异(P> 0. 05);治疗后,两组患者iPTH和P水平均较治疗前下降,而血钙水平较前上升,且观察组患者改善程度均显著优于对照组(P <0. 05);两组患者治疗前的肾功能比较无差异(P> 0. 05),治疗后两组患者血尿素氮(BUN)、血肌酐(SCr)和尿酸(UA)水平均较前降低,而内生肌酐清除率(CCr)较前升高,且观察组患者BUN下降程度明显优于对照组(P <0. 05);两组患者不良反应发生率比较无显著差异(P> 0. 05),均无明显严重不良反应发生。结论阿法骨化醇联合血液灌流与血液透析可显著降低CKD-MBD患者iPTH和血磷水平,提高其血钙水平,对肾功能也有一定改善作用,值得临床推广。Objective To investigate the effect of alfacalciferol combined with hemoperfusion and hemodialysis on calcium and phosphorus metabolism in patients with chronic kidney disease-mineral and bone anomalies（CKD-MBD）.nethods Totally 104 patients with CKD-MBD admitted to our hospital from December 2014 to January 2017 were selected. All patients were analyzed retrospectively and divided into the control group（50 cases） and the observation group（54 cases） according to the different treatment methods. The control group was given symptomatic treatment of CKD-MBD such as hemoperfusion and hemodialysis, on this basis, the observation group was treated with alfacalcidol. The two groups were treated for 12 weeks. Results There was no difference in the levels of the total parathyroid honnone（iPTH）, serum calcium（Ca） and phosphorus（P） between the two groups before treatment（P 〉 0.05）. After treat-ment, the levels of iPTH and P in the two groups were lower than those before treatment, while the levels of serum calcium in the two groups were higher than those before treatment, and the improvement of the observation group was more significant than that of the control group（P 〈 0.05）. There was no difference in renal function between the two groups before treatment（P 〉 0.05）. After treatment, the levels of BUN, SCr and UA in the two groups were lower than those before treatment, while the CCr in the two groups was higher than that before treatment. However, the decrease of BUN in the observation group was more significant than that in the control group（P 〈 0. 05）.No serious adverse reactions occurred in the two groups, and there was no significant difference in the incidence rare of adverse reactions between the two groups（P 〉 0.05）. Conclusion Alfacalciferol combined with hemoperfusion and hemodialysis can significantly reduce the levels of iPTH and serum phosphorus in patients with CKD-MBD and increase the level of serum calcium, it also can improve renal function, which is wo

关 键 词：阿法骨化醇 血液灌流 血液透析 慢性肾脏病-矿物质和骨异常 

分 类 号：R969.4[医药卫生—药理学] R977.5[医药卫生—药学]