西那卡塞、骨化三醇联合碳酸司维拉姆对血液透析继发性甲状旁腺功能亢进的疗效分析  

Analysis of the efficacy of cinacalcet and calcitriol combined with sevelamer carbonate in hemodialysis patients with secondary hyperparathyroidism

作　　者：唐洪波 叶晓燕 宋成虎 孙艳 TANG Hong-bo;YE Xiao-yan;SONG Cheng-hu(Department of Renal Rheumatology,Huiyang Sanhe Hospital,Huizhou 516211,China)

机构地区：[1]广东省惠州市惠阳三和医院肾内风湿科,516211

出　　处：《中国实用医药》2023年第14期106-109,共4页China Practical Medicine

摘　　要：目的分析西那卡塞、骨化三醇联合碳酸司维拉姆对血液透析继发性甲状旁腺功能亢进的疗效。方法78例血液透析继发性甲状旁腺功能亢进患者,根据随机数字表法分为对照组及观察组,每组39例。对照组患者给予碳酸司维拉姆、骨化三醇治疗,观察组采取西那卡塞、骨化三醇联合碳酸司维拉姆治疗。比较两组临床疗效、不良反应发生率及治疗前后骨钙素、碱性磷酸酶、腰椎L_(2~4)骨密度、磷离子、甲状旁腺体积、全段甲状旁腺激素水平。结果治疗后,两组骨钙素、碱性磷酸酶、腰椎L_(2~4)骨密度、磷离子、甲状旁腺体积、全段甲状旁腺激素水平均较本组治疗前改善,且观察组骨钙素、碱性磷酸酶、腰椎L_(2~4)骨密度、磷离子、甲状旁腺体积、全段甲状旁腺激素水平分别为(122.08±11.26)ng/ml、(101.58±12.26)U/L、(0.99±0.05)g/cm^(2)、(1.31±0.11)mmol/L、(0.78±0.11)cm^(3)、(804.45±51.24)pg/ml,优于对照组的(154.28±21.12)ng/ml、(193.21±21.12)U/L、(0.80±0.04)g/cm^(2)、(1.83±0.15)mmol/L、(1.01±0.15)cm^(3)、(924.13±123.01)pg/ml,差异有统计学意义(P<0.05)。观察组总有效率94.87%(37/39)高于对照组的71.79%(28/39),差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论西那卡塞、骨化三醇联合碳酸司维拉姆治疗血液透析继发性甲状旁腺功能亢进的效果确切,可改善患者临床症状和甲状旁腺功能,安全有效。Objective To analyze the efficacy of cinacalcet and calcitriol combined with sevelamer carbonate in hemodialysis patients with secondary hyperparathyroidism.Methods A total of 78 cases of hemodialysis patients with secondary hyperparathyroidism were divided into control group and observation group according to random numerical table,with 39 cases in each group.The control group was treated with sevelamer carbonate and calcitriol,while the observation group was treated with cinacalcet and calcitriol combined with sevelamer carbonate.Both groups were compared in terms of clinical efficacy,incidence of adverse reactions,osteocalcin,alkaline phosphatase,lumbar(L_(2-4))bone mineral density,phosphorus ion,parathyroid volume and intact parathyroid hormone level before and after treatment.Results After treatment,the osteocalcin,alkaline phosphatase,lumbar(L_(2-4))bone mineral density,phosphorus ion,parathyroid volume,and intact parathyroid hormone levels in both groups were better than those before treatment in this group;in the observation group,the osteocalcin,alkaline phosphatase,lumbar(L_(2-4))bone mineral density,phosphorus ion,parathyroid volume,and intact parathyroid hormone levels were(122.08±11.26)ng/ml,(101.58±12.26)U/L,(0.99±0.05)g/cm^(2),(1.31±0.11)mmol/L,(0.78±0.11)cm^(3),and(804.45±51.24)pg/ml,which were better than those of(154.28±21.12)ng/ml,(193.21±21.12)U/L,and(0.80±0.04)g/cm^(2),(1.83±0.15)mmol/L,(1.01±0.15)cm^(3),and(924.13±123.01)pg/ml in the control group;the differences were statistically significant(P<0.05).The total effective rate of was 94.87%(37/39)in the observation group higher than that of 71.79%(28/39)in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The treatment of secondary hyperparathyroidism during hemodialysis with cinacalcet,calcitriol,and sevelamer carbonate has a definite effect,which can improve the clinical sympt

关 键 词：西那卡塞 骨化三醇 碳酸司维拉姆 血液透析继发性甲状旁腺功能亢进 疗效 

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