西那卡塞对慢性肾衰血液透析致SHPT患者钙磷代谢及PTH水平的影响  

Effect of Cinacalcet on Calcium and Phosphorus Metabolism and PTH Level in Patients with SHPT Caused by Hemodialysis of Chronic Renal Failure

作　　者：黄华桑[1] 王捷 杨忠民[1] HUANG Huasang;WANG Jie;YANG Zhongmin(The First Hospital of Quanzhou City,Quanzhou 362000,China;不详)

机构地区：[1]泉州市第一医院,福建泉州362000

出　　处：《中外医学研究》2020年第6期17-19,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨西那卡塞对慢性肾衰血液透析致继发性甲状旁腺功能亢进(SHPT)患者钙磷代谢及甲状旁腺激素(PTH)水平的影响。方法:选择2017年7月-2019年6月笔者所在医院收治的慢性肾衰血液透析致SHPT患者80例,按随机数字表法将其分为两组,各40例。对照组接受骨化三醇治疗,观察组则加用西那卡塞治疗。比较两组临床疗效、血清全段甲状旁腺激素(iPTH)、钙磷代谢、成纤维细胞生长因子23(FGF23)及不良反应。结果:观察组总有效率(95.00%)高于对照组(80.00%),差异有统计学意义(P<0.05);两组治疗前血钙、血磷、iPTH、FGF23水平对比,差异无统计学意义(P>0.05);治疗后观察组血钙(2.49±0.17)mmol/L,高于对照组的(2.27±0.13)mmol/L,血磷(1.23±0.11)mmol/L、iPTH(216.76±18.49)ng/L、FGF23(519.42±114.36)pg/ml,低于对照组的(1.56±0.23)mmol/L、(311.93±31.52)ng/L、(621.73±135.07)pg/ml,差异有统计学意义(P<0.05);观察组、对照组不良反应发生率(10.00%、5.00%)相比,差异无统计学意义(P>0.05)。结论:慢性肾衰血液透析致SHPT患者接受西那卡塞有助于维持钙磷平衡,改善PTH水平,下调FGF23水平,安全性、有效性较高。Objective:To investigate the effects of Cinacalcet on calcium and phosphorus metabolism and parathyroid hormone(PTH)levels in patients with secondary hyperparathyroidism(SHPT)induced by hemodialysis of chronic renal failure.Method:Eighty patients with SHPT who were treated with hemodialysis in chronic renal failure and were enrolled in our hospital from July 2017 to June 2019.They were divided into two groups according to the random number table method,40 cases in each.The control group received Calcitriol and the observation group was treated with Cinacalcet.The clinical efficacy,serum total parathyroid hormone(iPTH),calcium and phosphorus metabolism,fibroblast growth factor 23(FGF23)and adverse reactions were compared between the two groups.Result:The total effective rate of the observation group(95.00%)was higher than 80.00%of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in blood calcium,serum phosphorus,iPTH and FGF23 levels between the two groups before treatment(P>0.05).Blood calcium(2.49±0.17)mmol/L in the observation group after treatment,was higher than(2.27±0.13)mmol/L in the control group,blood phosphorus(1.23±0.11)mmol/L,iPTH(216.76±18.49)ng/L,FGF23(519.42±114.36)pg/ml,lower than(1.56±0.23)mmol/L,(311.93±31.52)ng/L,(621.73±135.07)pg/ml in the control group,the difference was statistical significance(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group of 10.00%,5.00%(P>0.05).Conclusion:Cinacalcet for patients with SHPT induced by hemodialysis in chronic renal failure can help maintain calcium and phosphorus balance,improve PTH level,and down-regulate FGF23 level.It is safe and effective.

关 键 词：慢性肾衰 继发性甲状旁腺功能亢进 西那卡塞 血液透析 钙磷代谢 甲状旁腺激素 

分 类 号：R692.5[医药卫生—泌尿科学]