碳酸司维拉姆联合常规治疗对慢性肾衰竭合并高磷血症患者血清炎症因子及HO-1、iPTH水平的影响  

Effects of Sevelamer Carbonate Combined with Routine Treatment on Serum Inflammatory Factors,HO-1 and iPTH Levels of Chronic Renal Failure Patients with Hyperphosphatemia

作　　者：刘智楠[1] 郑慧[1] 郭向辉 LIU Zhinan;ZHENG Hui;GUO Xianghui(Dept.of Renal Internal Medicine,Tangshan Worker’s Hospital,Hebei Tangshan 063000,China)

机构地区：[1]唐山市工人医院肾内科,河北唐山063000

出　　处：《中国药房》2018年第5期683-686,共4页China Pharmacy

摘　　要：目的:探讨碳酸司维拉姆联合常规治疗对慢性肾衰竭(CRF)合并高磷血症患者血清炎症因子及血红素氧化酶1(HO-1)、全段甲状旁腺激素(i PTH)水平的影响。方法:将2014年1月-2015年1月唐山市工人医院肾内科确诊为CRF合并高磷血症患者60例按随机数字表法分为对照组和观察组,各30例。对照组患者给予降糖、降脂、降压、降磷、保护肾脏等临床常规方法治疗,观察组患者在对照组治疗基础上给予碳酸司维拉姆(剂量0.8 g,每天3次,餐中服药),疗程均为4周。比较两组患者血清中白细胞介素6(IL-6)、C反应蛋白(CRP)、HO-1、i PTH和钙、磷水平,并比较两组患者不良反应发生情况。结果:因两组患者在治疗过程中均有2例退出,故最终两组纳入数分别为28例。治疗前,两组患者血清各指标水平差异均无统计学意义(P>0.05)。与治疗前比较,两组患者治疗后血清中IL-6、CRP、i PTH、磷水平均显著降低(P<0.05),血清钙水平显著升高(P<0.05),且观察组患者上述指标较对照组改善更明显(P<0.05)。两组患者不良反应发生率差异无统计学意义(P>0.05)。结论:碳酸司维拉姆联合常规治疗后能更为有效地降低CRF合并高磷血症患者血清炎症因子(IL-6、CRP)和HO-1、i PTH水平,调节钙、磷代谢,且安全性较高。OBJECTIVE:To investigate the effects of sevelamer carbonate combined with routine treatment on serum inflammatory factors,heme oxygenase-1(HO-1)and intact parathyroid hormone(iPTH)levels of chronic renal failure(CRF)patients with hyperphosphatemia.METHODS:Totally 60 chronic renal failure patients with hyperphosphatemia in department of renal internal medicine,Tangshan Workers’Hospital during Jan.2014 to Jan.2015 were divided into control group and observation group according to random number table,with 30 cases in each group.Control group received routine treatment as reducing blood glucose,lowering blood lipid,lowering blood pressure,reducing phosphorus,protecting kidney.Observation group was additionally given sevelamer carbonate(dose was 0.8 g,3 times a day,during meal)on the basis of control group,for 4 weeks.The levels of IL-6,CRP,HO-1,iPTH,Ca and P were compared between 2 groups.The occurrence of ADR was compared between 2 groups.RESULTS:Two cases were withdrewn from the study in each group,finally 28 cases were included in the study in each group.Before treatment,there was no statistical significance in each index between 2 groups(P>0.05).Compared with before treatment,the serum levels of IL-6,CRP,iPTH and P in 2 groups were decreased significantly after treatment(P<0.05),while serum level of Ca was increased significantly(P<0.05);the improvement of above indexes in observation group were more dovious than control group(P<0.05).There was no statistical significance in the incidence of ADR between 2 groups(P>0.05).CONCLUSIONS:Sevelamer carbonate combined with routine treatment can effectively reduce the serum levels of IL-6,CRP,HO-1 and iPTH and regulate Ca and P metabolism of CRF patients with hyperphosphatemia with good safety.

关 键 词：碳酸司维拉姆 慢性肾衰竭 高磷血症 C反应蛋白 白细胞介素6 血红素氧化酶1 全段甲状旁腺激素 

分 类 号：R452[医药卫生—治疗学]