帕立骨化醇对维生素D不足/缺乏的血液透析患者预防继发性甲状旁腺功能亢进的探索性随机对照研究  

Prevention of secondary hyperparathyroidism in vitamin D deficiency/deficiency hemodialysis patients:an exploratory randomized controlled study

作　　者：陈雷 徐晓宇 郝丽[2] CHEN Lei;XU Xiaoyu;HAO Li(Hefei Jinnan Nephropathy Specialist Hospital,Anhui Province,Hefei 230000,China;不详)

机构地区：[1]合肥金楠肾病专科医院,合肥市230000 [2]安徽医科大学第二附属医院,合肥市230601

出　　处：《临床合理用药杂志》2022年第1期14-17,21,共5页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察低剂量帕立骨化醇预防维生素D不足/缺乏的血液透析患者继发性甲状旁腺功能亢进(SHPT)的有效性和安全性。方法回顾性选取2020年3-5月合肥金楠肾病专科医院收治的接受血液透析治疗伴维生素D不足/缺乏的慢性肾功能衰竭患者40例,根据治疗方法不同分为试验组24例和对照组16例,对照组行常规血液透析治疗,试验组给予帕立骨化醇5μg透析下机前静脉注射,每周1次。比较2组患者基线值、治疗24周后全段甲状旁腺激素(iPTH)、碱性磷酸酶(ALP)、血钙、血磷水平及不良事件。结果治疗24周后,试验组iPTH水平与基线值比较无显著变化(P>0.05),而对照组iPTH水平高于基线值(P<0.05);试验组iPTH水平变化幅度优于对照组(P<0.01)。治疗24周后,2组ALP水平与基线值比较差异均无统计学意义(P>0.05),但试验组变化幅度优于对照组(P<0.05)。治疗24周后,试验组血钙水平无显著变化(P>0.05),血磷水平低于基线值(P<0.01),而对照组血钙、血磷水平均无显著变化(P>0.05),治疗24周后2组血钙、血磷水平比较差异均无统计学意义(P>0.05)。2组不良事件发生率比较差异均无统计学意义(P>0.05)。结论对维生素D不足/缺乏的血液透析患者早期给予低剂量帕立骨化醇预防,可延缓SHPT疾病进展,降低血清磷水平,改善骨代谢,有利于稳定骨代谢内环境。Objective To observe the efficacy and safety of low-dose paricalcitol in the prevention of secondary hyperparathyroidism(SHPT)in patients with vitamin D deficiency/deficiency on hemodialysis.Methods A retrospective study was performed on 40 patients with chronic renal failure complicated with vitamin D deficiency and treated by hemodialysis in Hefei Jinnan Nephropathy Specialist Hospital from March to May in 2020.According to different treatment methods,they were divided into experimental group 24 cases and control group 16 cases.The control group received routine hemodialysis,and the experimental group received 5μg paricalcitol intravenously before dialysis,once a week,the whole parathyroid hormone(iPTH),alkaline phosphatase(ALP),blood calcium,blood phosphorus levels and adverse events were compared between 2 groups baseline value and after 24 weeks of treatment.Results After 24 weeks of treatment,there was no significant change in iPTH level of experimental group compared with baseline value(P>0.05),while iPTH level of control group was higher than baseline value(P<0.05).The change range of iPTH level in experimental group was better than that in control group(P<0.01).After 24 weeks of treatment,there were no significant difference in ALP levels between the two groups compared with baseline(P>0.05),but the range of change in experimental group was better than that in control group(P<0.05).After 24 weeks of treatment,there was no significant change in serum calcium level in experimental group(P>0.05),and serum phosphorus level was lower than baseline value(P<0.01),while there were no significant change in serum calcium and serum phosphorus levels in control group(P>0.05),but there were no statistical significance in serum calcium and serum phosphorus levels between 2 groups after 24 weeks of treatment(P>0.05).There was no significant difference in the incidence of adverse events between 2 groups(P>0.05).Conclusion Early prevention of low dose paricalcitol in patients with vitamin D deficiency/deficiency on hemo

关 键 词：维生素D不足/缺乏 继发性甲状旁腺功能亢进 帕立骨化醇 低剂量 

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