骨化三醇联合西那卡塞治疗维持性血液透析患者并发继发性甲状旁腺功能亢进的临床疗效及安全性  

Clinical effect of calcitriol combined with cinacarbose in the treatment of patients with maintenance hemodialysis complicated with secondary hyperparathyroidism

作　　者：崔宁 苗新红 庄新颖 CUI Ning;MIAO Xinhong;ZHUANG Xinying(Department of Nephrology,Sujiatun District Maternal and Infant Hospital of Shenyang City,Shenyang 110101,China)

机构地区：[1]辽宁省沈阳市苏家屯区妇婴医院肾内科,110101

出　　处：《临床合理用药杂志》2021年第30期19-22,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的分析骨化三醇联合西那卡塞治疗维持性血液透析(MHD)患者并发继发性甲状旁腺功能亢进(SHPT)的临床疗效及安全性,旨在为临床医师选择用药方案提供参考。方法选取2017—2020年沈阳市苏家屯区妇婴医院收治的并发SHPT的MHD患者338例作为研究对象,根据随机数字表法将患者分为对照组和观察组,每组169例。对照组患者仅接受西那卡塞治疗,观察组患者接受骨化三醇联合西那卡塞治疗,2组患者均治疗10周。比较2组患者治疗总有效率及治疗前后实验室检查指标[包括全段甲状旁腺激素(iPTH)、血钙、血磷、钙磷乘积及碱性磷酸酶(ALP)];记录2组患者治疗期间不良反应发生情况及治疗后临床症状。结果观察组治疗总有效率高于对照组(P<0.05)。治疗前,2组患者iPTH、血钙、血磷、钙磷乘积及ALP比较,差异无统计学意义(P>0.05);治疗后,观察组患者i PTH、血磷及ALP低于对照组,血钙、钙磷乘积高于对照组(P<0.05)。观察组不良反应发生率及治疗后骨痛、皮肤瘙痒发生率低于对照组(P<0.05);2组患者治疗后皮下组织钙化及不宁腿综合征发生率比较,差异无统计学意义(P>0.05)。结论骨化三醇联合西那卡塞治疗MHD患者并发SHPT的临床疗效确切,能有效抑制iPTH分泌,稳定血磷、血钙水平,改善临床症状,且安全性较高。Objective To explore the clinical efficacy and safety of calcitriol combined with cinacarbose in the treatment of maintenance hemodialysis(MHD)complicated with secondary hyperparathyroidism(SHPT),in order to provide reference for clinicians to choose drug use regimen.Methods From 2017 to 2020,a total of 338 patients with MHD complicated with SHPT in Sujiatun District Maternal and Infant Hospital of Shenyang City were selected as the research subjects.According to the random number table method,the research subjects were divided into the control group and the observation group,169 cases in each group.The patients in the control group were only treated with cinacarbose,and the patients in the observation group were treated with calcitriol combined with cinacarbose.Both groups were treated for 10 weeks.The total effective rate and laboratory indexes[including iPTH,blood calcium,blood phosphorus,calcium phosphorus product and alkaline phosphatase(ALP)]before and after treatment were compared between the two groups;and the incidence of adverse reactions during treatment and clinical symptoms after treatment of the two groups were recorded.Results The total effective rate in the observation group was higher than that in the control group(P<0.05).Before treatment,there was no significant difference in iPTH,blood calcium,blood phosphorus,calcium phosphorus product and ALP between the two groups(P>0.05);after treatment,iPTH,blood phosphorus and ALP in the observation group were lower than those in the control group,and the blood calcium and calcium phosphorus product were higher than those in the control group(P<0.05).The incidence of adverse reactions,bone pain and skin pruritus in the observation group were lower than those in the control group(P<0.05);there was no significant difference in the incidence of subcutaneous tissue calcification and restless leg syndrome between the two groups(P>0.05).Conclusion The clinical efficacy of calcitriol combined with cinacarbose in the treatment of patients with MHD complicated wi

关 键 词：维持性血液透析 继发性甲状旁腺功能亢进 骨化三醇 西那卡塞 治疗结果 

分 类 号：R692.5[医药卫生—泌尿科学] R582.1[医药卫生—外科学]