西那卡塞联合骨化三醇对维持性血液透析伴SHPT患者碱性磷酸酶、钙磷代谢、KT/V的影响  

Effects of Cinacalcet Combined with Calcitriol on Alkaline Phosphatase,Calcium-phosphorus Metabolism and KT/V in Patients with Maintenance Hemodialysis Complicated with SHPT

作　　者：黄娜 HUANG Na(First People’s Hospital of Fuzhou,Jiangxi Province,Fuzhou 344000,China)

机构地区：[1]江西省抚州市第一人民医院,江西抚州344000

出　　处：《中国医学创新》2022年第31期1-5,共5页Medical Innovation of China

基　　金：抚州市指导性科技计划项目(抚科计字[2021]7号-16);江西省科技厅项目(20164BCD40095)。

摘　　要：目的:探究西那卡塞联合骨化三醇治疗对维持性血液透析(MHD)伴继发性甲状旁腺功能亢进(SHPT)患者碱性磷酸酶(ALP)、钙磷代谢、尿素清除指数(KT/V)的影响。方法:选取2021年8月-2022年4月于抚州市第一人民医院就诊的MHD伴SHPT患者78例为研究对象,采用简单随机法将其分为研究组(n=39)和对照组(n=39)。对照组给予骨化三醇治疗,研究组在对照组的基础上联合西那卡塞治疗,两组均治疗4个月。比较两组治疗前后骨代谢指标[ALP、骨钙素(OC)、β-胶原蛋白(β-CTX)]、钙磷代谢指标[血钙(Ca)、血磷(P)、甲状旁腺素(PTH)、成纤维细胞生长因子23(FGF23)]、肾功能指标[KT/V、肾小球滤过率(GFR)、血肌酐(Scr)、尿酸(UA)]水平及不良反应发生情况。结果:治疗后,两组骨代谢指标、P、PTH、FGF23水平均低于治疗前,且研究组均低于对照组(P<0.05);治疗后,两组Ca水平均高于治疗前(P<0.05),但研究组与对照组比较差异无统计学意义(P>0.05);两组治疗前后KT/V、GFR、Scr、UA水平比较,差异均无统计学意义(P>0.05);研究组不良反应发生率(17.9%)与对照组(23.1%)比较,差异无统计学意义(P>0.05)。结论:西那卡塞联合骨化三醇可有效改善MHD伴SHPT患者钙磷代谢及骨代谢状态,且对患者肾功能影响较小,具有良好的安全性。Objective:To explore the effects of Cinacalcet combined with Calcitriol in the treatment of patients with maintenance hemodialysis (MHD) complicated with secondary hyperparathyroidism (SHPT) on alkaline phosphatase (ALP),calcium-phosphorus metabolism and urea clearance index (KT/V).Method:A total of 78 MHD patients with SHPT treated in First People’s Hospital of Fuzhou from August 2021 to April 2022 were selected as the research objects.They were divided into study group (n=39) and control group (n=39) by simple random method.The control group was treated with Calcitriol,and the study group was treated with Cinacalcet on the basis of the control group.Both groups were treated for 4 months.Bone metabolic indexes[ALP,osteocalcin (OC),β-collagen (β-CTX)],calcium-phosphorus metabolic indexes[serum calcium (Ca),serum phosphorus (P),parathyroid hormone (PTH),fibroblast growth factor 23 (FGF23)],renal function indexes[KT/V,glomerular filtration rate (GFR),serum creatinine (Scr),uric acid (UA)]before and after treatment and the incidence of adverse reactions were compared between the two groups.Result:After treatment,the levels of bone metabolism,P,PTH and FGF23 in the two groups were lower than those before treatment,and those in the study group were lower than those in the control group (P<0.05).After treatment,the levels of Ca in the two groups were higher than those before treatment (P<0.05),but there was no significant difference between the study group and the control group (P>0.05).There were no significant differences in KT/V,GFR,Scr and UA levels between the two groups before and after treatment (P>0.05).There was no significant difference in the incidence of adverse reactions between the study group (17.9%) and the control group (23.1%) (P>0.05).Conclusion:Cinacalcet combined with Calcitriol can effectively improve calcium-phosphorus metabolism and bone metabolism status in patients with MHD and SHPT,and has small effect on renal function and has good safety.

关 键 词：维持性血液透析 继发性甲状旁腺功能亢进 西那卡塞 骨化三醇 骨代谢 钙磷代谢 肾功能 

分 类 号：R692.5[医药卫生—泌尿科学]