骨化三醇不同给药方式联合西那卡塞治疗维持血透继发甲状旁腺功能亢进症的临床疗效  

Clinical efficacy of calcitriol in combination with silecase in the treatment of hyperparathyroidism secondary to hemodialysis

作　　者：南娜佳 朱琼琼 NAN Na-Jia;ZHU Qiong-qiong(Department of Nephrology,Yueqing People's Hospital,Wenzhou 325600,China)

机构地区：[1]乐清市人民医院肾内科,浙江温州325600

出　　处：《中国处方药》2023年第5期53-57,共5页Journal of China Prescription Drug

基　　金：温州市医药卫生科研项目(2021033)。

摘　　要：目的 探究西那卡塞联合骨化三醇不同给药方式治疗维持性血液透析(MHD)继发性甲状旁腺功能亢进症(SHPT)的疗效。方法 选取2020年6月~2022年3月期间收治的90例MHD继发SHPT患者为研究对象,根据治疗方法分为对照组与观察组,各45例。对照组给予西那卡塞联合骨化三醇持续性小剂量治疗,观察组给予西那卡塞联合骨化三醇间歇性大剂量治疗,治疗6个月。比较治疗前、治疗6个月后两组临床疗效,血清钙、血磷、全段甲状旁腺激素(iPTH)、血肌酐(Scr)、血尿素氮(BUN)水平,皮肤瘙痒、睡眠障碍发生率、骨痛视觉模拟评分(VAS),记录不良反应。结果 观察组总体有效率高于对照组(χ^(2)=5.075,P=0.024)。治疗后两组患者血钙水平升高,血磷、iPTH、Scr、BUN水平降低,皮肤瘙痒、睡眠障碍发生率及VAS降低(P<0.05),且观察组患者血钙水平高于对照组,血磷、iPTH、Scr、BUN水平低于对照组,皮肤瘙痒、睡眠障碍发生率及VAS低于对照组(P<0.05)。观察组患者的不良反应发生率低于对照组(χ^(2)=5.075,P=0.024)。结论 西那卡塞联合骨化三醇间歇性大剂量治疗MHD继发SHPT患者疗效显著,可有效改善钙磷指标及肾功能,不良反应少。Objective To investigate the clinical efficacy of different administration methods of sinacasse combined with calcitriol in the treatment of maintenance hemodialysis(MHD)patients with secondary hyperparathyroidism(SHPT).Methods 90 patients with SHPT secondary to MHD admitted from June 2020 to March 2022 were selected and divided into the control group and the observation group according to different treatment methods,with 45 patients in each group.The control group was treated with continuous low-dose treatment of sinacasse combined with calcitriol,while the observation group was treated with intermittent high-dose treatment of sinacasse combined with calcitriol for 6 months.The clinical effects of the two groups were compared before treatment and after 6 months of treatment.The levels of serum calcium,blood phosphorus,whole parathyroid hormone(iPTH),serum creatinine(Scr),blood urea nitrogen(BUN),the incidence of skin itching,sleep disorders,and visual analogue score(VAS)of bone pain were recorded.The adverse reactions were recorded.Results The overall effective rate of the observation group was higher than that of the control group(χ^(2)=5.075,P=0.024).After treatment,the blood calcium level of the two groups increased,the blood phosphorus,iPTH,Scr and BUN levels decreased,and the incidence of skin itching,sleep disorders and VAS decreased(P<0.05).In addition,the blood calcium level in the observation group was higher than that in the control group,the blood phosphorus,iPTH,Scr and BUN levels were lower than that in the control group,and the incidence of skin itching,sleep disorders and VAS were lower than those in the control group(P<0.05).The incidence of adverse time in the observation group was lower than that in the control group(χ^(2)=5.075,P=0.024).Conclusion The intermittent high-dose treatment of sinacasse combined with calcitriol for SHPT patients secondary to MHD has significant effect,can effectively improve calcium and phosphorus indicators and renal function,with less adverse reactions.

关 键 词：骨化三醇 西那卡塞 维持血透 继发甲状旁腺功能亢进症 

分 类 号：R582.1[医药卫生—内分泌]