西那卡塞对血液透析患者继发性甲状旁腺功能亢进症的疗效观察  

The effect of cinacalcet on secondary hyperparathyroidism in hemodialysis patients

作　　者：黄琳 李慧[1] 张艳[1] 唐红进 童昌军[1] HUANG Lin;LI Hui;ZHANG Yan;TANG Hongjin;TONG Changjun(Blood Purified Center,The Affiliated Yijishan Hospital of Wannan Medicial College,Wuhu,Anhui 241001,China;Department of Biopharmaceutical,Anhui Polytechnic University,Wuhu,Anhui 241000,China)

机构地区：[1]皖南医学院附属弋矶山医院血液净化中心,安徽芜湖241001 [2]安徽工程大学生物制药教研室,安徽芜湖241000

出　　处：《现代医药卫生》2021年第18期3066-3069,共4页Journal of Modern Medicine & Health

基　　金：安徽省高等学校自然科学研究重点项目(KJ2019A0152)。

摘　　要：目的探讨使用盐酸西那卡塞(盖平)治疗维持性血液透析(MHD)并发继发性甲状旁腺功能亢进(SHPT)患者的临床疗效。方法选取皖南医学院附属弋矶山医院血液净化中心维持性血液透析治疗大于或等于3个月且合并SHPT病例40例,随机分为观察组和对照组,各20例,比较两组患者给药前、治疗3个月后Ca^(2+)、P^(3-)、甲状旁腺激素(PTH)等水平变化及临床疗效。结果与对照组比较,观察组有效率、总有效率均高于对照组(P<0.05)。观察组治疗前后:Ca^(2+)(2.43±0.18)vs.(2.29±0.17)mmol/L(P<0.05),P^(3-)(1.85±0.48)vs.(1.41±0.32)mmol/L(P<0.05),Ca^(2+)*P 3-(55.60±14.33)vs.(39.99±8.92)mg 2/dL 2(P<0.05),PTH(798.21±198.67)vs.(379.05±175.22)pg/L(P<0.05);对照组仅PTH(668.77±245.15)vs.(519.11±176.77)pg/L(P<0.05),Ca^(2+)、P^(3-)差异均无统计学意义(P>0.05),且观察组治疗后PTH疗效显著高于对照组(379.05±175.22)vs.(519.11±176.77)pg/L(P<0.05)。结论盐酸西拉卡塞能有效降低MHD并发SHPT患者的Ca^(2+)、P^(3-)、PTH等水平,改善骨矿物质代谢紊乱。Objective To explore the clinical efficacy of cinacalcet hydrochloride(Gepin)in the treatment of maintenance hemodialysis(MHD)patients with secondary hyperparathyroidism(SHPT).Methods We selected 40 patients with MHD treatment≥3 months coupled with SHPT from the Blood Purification Center of our hospital,which were randomly divided into cinacalcet hydrochloride group and conventional treatment with 20 cases each.The changes in the levels of blood Ca^(2+),P^(3-),PTH,etc.were compared before and after 3 months to evaluate the clinical efficacy.Results Compared with the observation group,the effective rate and total effective rate of the cinacalcet group were higher than those of the observation group(P<0.05).The comparison of before and after the treatment of cinacalcet:Ca 2+(2.43±0.18)vs.(2.29±0.17)mmol/L(P<0.05),P 3-(1.85±0.48)vs.(1.41±0.32)mmol/L(P<0.05),Ca^(2+)*P^(3-)(55.60±14.33)vs.(39.99±8.92)mg 2/dL 2(P<0.05),PTH(798.21±198.67)vs.(379.05±175.22)pg/L(P<0.05).The observation group only:PTH(668.77±245.15)vs.(519.11±176.77)pg/L(P<0.05),and there was no significant difference in Ca 2+and P 3-(P>0.05).After the treatment of xylacaxide group,the efficacy of PTH was significantly higher than that in the observation group(379.05±175.22)vs.(519.11±176.77)pg/L(P<0.05).Conclusion Cinacalcet hydrochloride can effectively reduce the levels of Ca^(2+),P^(3-),PTH,etc.in MHD patients accompanied by SHPT,and improve bone mineral metabolism disorders.

关 键 词：西那卡塞 继发性甲状旁腺功能亢进症 维持性血液透析 慢性肾脏病 治疗效果 

分 类 号：R692.5[医药卫生—泌尿科学] R541[医药卫生—外科学]