西那卡塞联合高通量透析治疗中重度继发性甲状旁腺功能亢进的临床研究  

Clinical study of Cinacalcet combined with high-throughput dialysis in the treatment of moderate to severe secondary hyperparathyroidism

作　　者：於建根[1] 杨爱华[1] 张小云[1] 沈丽君[2] 朱华[3] YU Jian-gen;YANG Ai-hua;ZHANG Xiao-yun;SHEN Li-jun;ZHU Hua(Department of Nephrology,Hangzhou Xiaoshan District First People′s Hospital,Zhejiang Province,Hangzhou311200,China;Department of Ultrasound,Hangzhou Xiaoshan District First People′s Hospital,Zhejiang Province,Hangzhou311200,China;Hemodialysis Room,Hangzhou Xiaoshan District First People′s Hospital,Zhejiang Province,Hangzhou311200,China)

机构地区：[1]杭州市萧山区第一人民医院肾内科,浙江杭州311200 [2]杭州市萧山区第一人民医院超声科,浙江杭州311200 [3]杭州市萧山区第一人民医院血透室,浙江杭州311200

出　　处：《中国当代医药》2021年第3期45-47,共3页China Modern Medicine

基　　金：浙江省杭州市科技计划引导项目(20171226Y83)。

摘　　要：目的研究西那卡塞联合高通量透析(HFD)治疗中重度继发性甲状旁腺功能亢进(SHPT)的临床效果。方法选取2018年2月~2020年2月杭州市萧山第一人民医院收治的80例中重度SHPT患者作为研究对象,按照随机数字表法分为试验组(40例)与对照组(40例)。对照组采用HFD方法,试验组采用西那卡塞+HFD治疗方法,比较两组的甲状腺长、宽、厚、体积及生化指标水平。结果治疗前,两组甲状腺的长、宽、厚、体积比较,差异无统计学意义(P>0.05)。治疗后两组的甲状腺长、宽、厚、体积低于治疗前,差异有统计学意义(P<0.05)。试验组治疗后的甲状腺长、宽、厚、体积低于对照组,差异有统计学意义(P<0.05)。治疗前两组的生化指标水平比较,差异无统计学意义(P>0.05)。对照组治疗后的血清钙含量高于治疗前,试验组治疗后的血清钙含量低于治疗前,两组治疗后的磷、免疫反应性甲状旁腺激素(iPTH)、血清碱性磷酸酶(ALP)含量低于治疗前,差异有统计学意义(P<0.05)。试验组治疗后的血清钙、磷、iPTH、ALP含量低于对照组,差异有统计学意义(P<0.05)。结论西那卡塞联合HFD治疗中重度SHPT患者,有助于缩小甲状腺体积,促进生化指标恢复至合理范围,较单一透析治疗效果更佳。Objective To study the clinical effect of Cinacalcet combined with high-throughput dialysis(HFD)in the treatment of moderate to severe secondary hyperparathyroidism(SHPT).Methods Eighty patients with moderate to severe SHPT admitted to Hangzhou Xiaoshan District First People′s Hospital,Zhejiang Province from February 2018 to February 2020 were selected as the research objects.According to the random number table method,they were divided into the experimental group(40 cases)and the control group(40 cases).The control group used HFD,and the experimental group used Cinacalcet+HFD.The thyroid length,width,thickness,volume and biochemical index levels of the two groups were compared.Results Before treatment,there were no significant differences in thyroid length,width,thickness and volume between the two groups(P>0.05).After treatment,the thyroid length,width,thickness,and volume of the two groups after treatment were lower than those before treatment,and the differences were statistically significant(P<0.05).The thyroid length,width,thickness,and volume of the experimental group after treatment were lower than those of the control group,and the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the levels of biochemical indexes between the two groups(P>0.05).The serum calcium content of the control group after treatment was higher than that before treatment,the serum calcium of the experimental group after treatment was lower than that before treatment,and the contents of phosphorus,immunoreactive parathyroid hormone(iPTH)and serum alkaline phosphatase(ALP)in two groups after treatment were lower than those before treatment,and the differences were statistically significant(P<0.05).The serum calcium,phosphorus,iPTH and ALP contents of the experimental group after treatment were lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion Cinacalcet combined with HFD can more effectively control blood calcium,blo

关 键 词：西那卡塞 高通量透析 继发性甲状旁腺功能亢进 

分 类 号：R582.1[医药卫生—内分泌]