西那卡塞联合骨化三醇治疗血液透析继发性甲旁亢的疗效观察  

Observation on therapeutic effect of sinacase combined with calcitriol for the treatment of maintenance hemodialysis with secondary hyperparathyroidism

作　　者：李俊[1] 沈颖[1] 谢瑜[1] 杨德兴[2] 杜君 刘进进 LI Jun;SHEN Ying;XIE Yu;YANG De-xing;DU Jun;LIU Jin-jin(Department of Nephrology,The Affiliated Hospital of Kunming University of Science and Technology,The First people's Hospital of Yunnan Province,Kunming Yunnan 650000,China;Department of Emergency Medicine,The Affiliated Hospital of Kunming University of Science and Technology,The First people's Hospital of Yunnan Province,Kunming Yunnan 650000,China;Department of Nephrology,Chongqing Rongchang District Hospital of Traditional Chinese Medicine,Chongqing 402406,China;Department of Clinical Medicine,Medical School of Kunming University of Science and Technology,Kunming Yunnan 650000,China)

机构地区：[1]云南省第一人民医院昆明理工大学附属医院肾内科,云南昆明650000 [2]云南省第一人民医院昆明理工大学附属医院急诊内科 [3]重庆市荣昌区中医院肾病科,重庆402406 [4]昆明理工大学医学院临床医学部,云南昆明650000

出　　处：《云南医药》2022年第3期5-9,共5页Medicine and Pharmacy of Yunnan

基　　金：云南省“万人计划”名医专项:云财社(2019) 70号。

摘　　要：目的 探讨西那卡塞联合骨化三醇治疗MHD合并SHPT的治疗效果。方法 选取2017年1月-2018年9月本院收治的MHD合并SHPT患者58例。在严格饮食管理基础上,对MHD患者给予口服西那卡塞25~75 mg/d,同时口服骨化三醇胶丸0.25μg/d治疗12个月。比较治疗前、治疗后患者的血钙、血磷、钙磷乘积、碱性磷酸酶、 iPTH、甲状旁腺大小的变化,并将iPTH以1000 pg/mL为基值分为iPTH <1000 pg/mL组及iPTH≥1000 pg/mL组,比较2组治疗效果,使用SPSS17.0软件进行统计学分析。结果 58例患者治疗前iPTH水平为(1326.65±534.50) pg/mL,治疗后患者血钙、血磷、钙磷乘积、 iPTH、甲状旁腺体积明显低于治疗前,差异有统计学意义(P<0.05),治疗过程中所有患者无严重不良反应发生。结论 西那卡塞联合骨化三醇治疗能有效降低MHD合并SHPT患者的iPTH水平,在改善患者钙、磷代谢紊乱的基础下,还能缩小患者甲状旁腺体积,不良反应发生率低,临床疗效好、安全性高,值得临床广泛推广。Objective To discuss investigate the therapeutic effect of sinakase combined with calcitriol for the treatment of MHD with SHPT.Methods It selected 58 MHD patients complicated with SHPT who treated in our hospital from Jan.2017 to Sep.2018.On the basis of strict dietary management,MHD patients were given sinakase 25~75 mg/D and calcitriol capsule 0.25 mg/dμG/D for 12 months.The changes of blood calcium,blood phosphorus,calcium-phosphorus product,alkaline phosphatase,iPTH and parathyroid size were compared before and after the treatment.IPTH was divided into iPTH<1000 pg/mL group and iPTH≥1000 pg/mL group based on 1000 pg/mL.The treatment effects of the two groups were compared and statistically analyzed by SPSS17.0 software.Results The iPTH level of 58 patients before the treatment was(1326.65±534.50)pg/mL.After the treatment,the blood calcium,blood phosphorus,calcium phosphorus product,iPTH and parathyroid volume were significant lower than those before the treatment,there was statistical significance in the difference(P<0.05).There was no adverse reaction of all patients in therapeutic process.Conclusions Sinacase combined with calcitriol can effectively reduce the level of iPTH in patients with MHD complicated with SHPT.On the basis of improving the disorder of calcium and phosphorus metabolism for patients,it can also reduce the volume of parathyroid gland,and with low incidence of adverse reactions,good clinical efficacy and high safety.It is worthy to be widely popularized in clinic.

关 键 词：西那卡塞 骨化三醇 维持性血液透析 继发性甲状旁腺功能亢进 

分 类 号：R582.1[医药卫生—内分泌]