碳酸镧联合低钙透析对高龄维持性血液透析患者钙磷代谢和全段甲状旁腺激素的影响  

Effects of Lanthanum Carbonate Combined with Low Calcium Dialysis on Calcium and Intact Phosphorus Metabolism and Parathyroid Hormone in Elderly Patients with Maintenance Hemodialysis

作　　者：王利娟 梁巧静 孙晓媚[1] 陈燊[1] WANG Lijuan;LIANG Qiaojing;SUN Xiaomei;CHEN Shen(Hemodialysis Center,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院血液透析中心,北京100730

出　　处：《中国医院用药评价与分析》2021年第8期959-962,共4页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:探讨碳酸镧联合低钙透析对高龄维持性血液透析患者钙磷代谢和全段甲状旁腺激素(iPTH)的影响。方法:选取2019年1月至2020年3月首都医科大学附属北京同仁医院血液透析中心收治的高龄维持性血液透析患者60例作为研究对象,按随机数字表法分为两组。观察组30例患者采用碳酸镧联合低钙透析治疗,对照组30例患者采用碳酸钙联合低钙透析治疗。观察、记录两组患者治疗前,治疗后1、2和3个月的血钙水平、血磷水平、钙磷乘积、iPTH水平和不良反应发生情况,并进行统计学分析。结果:观察组患者治疗后的血钙水平、血磷水平和钙磷乘积较治疗前明显降低,差异均有统计学意义(P<0.05);对照组患者治疗后的血钙水平、血磷水平和钙磷乘积与治疗前比较,差异均无统计学意义(P>0.05);治疗后,两组患者上述指标水平比较,差异均有统计学意义(P<0.05)。两组患者治疗后的iPTH水平均较治疗前明显降低,但观察组患者降低幅度更明显,差异均有统计学意义(P<0.05)。观察组患者的不良反应总发生率为33.33%(10/30),显著高于对照组的6.67%(2/30),差异有统计意义(P<0.05)。结论:碳酸镧联合低钙透析能够有效降低高龄维持性血液透析患者的血钙、血磷、钙磷乘积和iPTH水平,有助于纠正高钙及高磷血症、预防甲状旁腺功能亢进和调节骨物质代谢异常以防止低转化骨病,但不良反应发生率稍高,临床应用中应注意不良反应的防治。OBJECTIVE:To probe into the effects of lanthanum carbonate combined with low calcium dialysis on calcium and phosphorus metabolism and intact parathyroid hormone(iPTH)in elderly patients with maintenance hemodialysis.METHODS:Totally 60 elderly patients with maintenance hemodialysis admitted into Hemodialysis Center,Beijing Tongren Hospital,Capital Medical University from Jan.2019 to Mar.2020 were extracted to be divided into two groups via the random number table.The observation group(n=30)was treated with low calcium dialysis combined with lanthanum carbonate,while the control group(n=30)received low calcium dialysis combined with calcium carbonate.The serum calcium,serum phosphorus,calcium phosphorus product,iPTH and adverse drug reactions of two groups were observed and recorded before treatment,after treatment of 1 month,2 months and 3 months.And statistical analysis was performed.RESULTS:The serum calcium,serum phosphorus and calcium phosphorus product of the observation group after treatment were significantly lower than those before treatment,and the difference was statistically significant(P<0.05).Compared with before treatment,there was no statistically significant difference in serum calcium,serum phosphorus and calcium-phosphorus product in the control group after treatment(P>0.05).The difference of the above indicators after treatment between two groups was statistically significant(P<0.05).After treatment,the levels of iPTH in two groups were significantly lower than those before treatment,yet the reduction in the observation group was more significant,and the difference was statistically significant(P<0.05).The total incidence of adverse drug reactions in the observation group was 33.33%(10/30),significantly higher than that in the control group(6.67%,2/30),the difference was statistically significant(P<0.05).CONCLUSIONS:Lanthanum carbonate combined with low calcium dialysis can effectively reduce the serum calcium,serum phosphorus,calcium phosphorus product and iPTH in elderly patients with mainten

关 键 词：高龄 维持性血液透析 碳酸镧 钙磷代谢 全段甲状旁腺激素 

分 类 号：R97[医药卫生—药品]