西那卡塞联合骨化三醇治疗维持性血液透析合并继发性甲状旁腺功能亢进患者的疗效观察  

Effectiveness of cinacalcet in combination with calcitriol for secondary hyperparathyroidism in patients with maintenance hemodialysis

作　　者：孙桂江[1,2] 魏芳 于海波[1,2] 李博 陈海燕[1,2] 张瑞宁 王博[1,2] 孟甲 董红业[1,2] 姜埃利 Sun Guifiang;Wei Fang;Yu Haibo;Li Bo;Chen Haiyan;Zhang Ruining;Wang Bo;Meng Jia;Dong Hongye;Jiang Aili(Department of Kidney Disease and Blood Purification Treatment,Tianfin Institute of Urology,the Second Hospital,Tianjin Medical University,Tianjin 300211,China)

机构地区：[1]天津医科大学第二医院肾脏病血液净化治疗科,300211 [2]天津市泌尿外科研究所

出　　处：《中华全科医师杂志》2018年第9期717-720,共4页Chinese Journal of General Practitioners

摘　　要：选取天津医科大学第二医院2012年6月至2017年6月维持性血液透析合并继发性甲状旁腺功能亢进的患者120例，采用随机数字表法分为3组，骨化三醇组、西那卡塞组和联合治疗组，每组40例。观察12个月，每个月复查患者的血钙、血磷、血全段甲状旁腺激素（iPTH）、心脏彩超、骨质疏松、软组织钙化、肾功能和血常规。3组患者经12个月的治疗后iPTH水平均有明显的下降，联合治疗组iPTH下降幅度最大（P〈0．01），且对血钙影响较小。治疗后碱性磷酸酶、骨质疏松和心脏瓣膜钙化较治疗前无明显变化。联合治疗组未出现高钙血症和低钙血症并发症。提示西那卡塞联合骨化三醇降低iPTH较单独用药效果更好。One hundred and twenty maintenance hemodialysis patients with secondary hyperparathyroidism were randomly assigned to receive cinacalce, calcitriol or combination of cinacalce and cacitriol for treatment, with 40 cases in each group. Patients were followed up for 12 months; and the blood tests, echocardiography, examinations for osteoporosis and soft tissue calcification were performed every month. After 3 months of treatment, the serum levels of parathyroid hormone were decreased in all three groups （ P 〈 0. 01 ） ; while the parathyroid hormone decreased more markedly with less influence on serum calcium and phosphorus levels in combination group. There were no significant changes in alkaline phosphatase, osteoporosis and cardiac valve calcification after treatment, compared with before treatment. There were no cases of hypercalcemia and hypocalcemia appearing in combination group after treatment. The study indicates that the combination of cinacalcet with calcitriol has better therapeutic effect for treatment of secondary hyperparathyroidism in maintenance dialysis patients.

关 键 词：血液透析 继发甲状旁腺功能亢进 西那卡塞 骨化三醇 

分 类 号：R692.5[医药卫生—泌尿科学]