帕立骨化醇联合碳酸镧治疗血液透析患者继发甲状旁腺功能亢进症的疗效分析  

Efficacy analysis of Parisol combined with lanthanum carbonate in the treatment of hyperparathyroidism in hemodialysis patients

作　　者：王泽敏 邵国建 郑约楠 潘璐璐 郑谊谊 WANG Zemin;SHAO Guojian;ZHENG Yuenan;PAN Lulu;ZHENG Yiyi(Hemodialysis Center of Wenzhou Central Hospital,Wenzhou 325000,Zhejiang,China)

机构地区：[1]浙江省温州市中心医院血液净化中心,浙江温州325000

出　　处：《中国现代医生》2022年第20期74-77,共4页China Modern Doctor

摘　　要：目的探讨帕立骨化醇针联合碳酸镧治疗血液透析患者继发性甲状旁腺功能亢进症的疗效。方法选取2018年6月1日至2021年12月31日在浙江省温州市中心医院院行维持性血液透析患者60例,分成帕立骨化醇联合碳酸镧组(观察组)、帕立骨化醇组(对照组),每组各30例,所有病例均治疗12周,每个月复查血清钙、磷及甲状旁腺素(parathyroid hormone,PTH),并调整药物剂量,第12周复查腹部动脉钙化(abdominal artery calcification,AAC)评分,观察患者治疗前后钙磷指标、PTH及AAC评分的变化。结果两组治疗第4周、8周、12周,PTH较治疗前相比均明显下降(P<0.05),但观察组下降较对照组更明显。观察组中,治疗后血磷较治疗前明显下降(P<0.05),血钙治疗前后比较,差异无统计学意义(P>0.05)。对照组中,治疗后血磷较治疗前明显上升(P<0.05),血钙在治疗后第8周、第12周较治疗前明显升高(P<0.05)。观察组与对照组治疗后12周AAC评分较治疗前均下降(P<0.05),但两组治疗12周后AAC评分比较,差异无统计学意义(P>0.05)。结论帕立骨化醇联合碳酸镧能更好的改善患者继发性甲状旁腺功能亢进,更有效降低PTH,并维持钙磷平衡。Objective To investigate the effect of paricalcitol combined with lanthanum carbonate in the treatment of hyperparathyroidism in patients with end-stage renal failure.Methods A total of 60 patients with end-stage renal failure secondary hyperparathyroidism(SHPT)who received hemodialysis in our hospital from January 1st 2018 to December 31st 2021 were selected as the research subjects.They were divided into two groups,of paricalcitol combined with Lanthanum Carbonate(observation group)and Parosteol group(control group).Serum calcium,phosphorus and parathyroid hormone(PTH)were rechecked every 4 weeks and the dose was adjusted.Abdominal artery calcification(AAC)Score was rechecked at 12 weeks.All cases treated for 12 weeks,the change of calcium,phosphorus,PTH and AAC Score before and after treatment were compared.Results At the 4th,8th and 12th week,PTH in the observation group and the control group decreased significantly compared with that before treatment(P<0.05),but the decrease in the observation group was more obvious than that in the control group.In the observation group,serum phosphorus after treatment was significantly lower than that before treatment(P<0.05),and there was no significant statistical difference in serum calcium before and after treatment(P>0.05).In the control group,the serum Phosphorus was significantly increased after treatment(P<0.05),and the serum calcium was significantly increased at 8 and 12 weeks after treatment(P<0.05).AAC score in the observation group and the control group at 12 weeks after treatment was lower than that before treatment(P<0.05).But there was no significant difference in AAC score between the two groups 12 weeks after treatment(P>0.05).Conclusion Parlisol combined with lanthanum carbonate can better improve secondary hyperparathyroidism in patients,reduce PTH more effectively,and maintain calcium and phosphorus balance.

关 键 词：帕立骨化醇 碳酸镧 维持性血液透析 继发性甲状旁腺功能亢进症 钙磷代谢紊乱 

分 类 号：R459.5[医药卫生—治疗学]