西那卡塞联合碳酸镧对维持性血液透析并SHP患者钙磷代谢及尿素清除指数的影响  

Effects of cinacalcet combined with lanthanum carbonate on calcium-phosphorus metabolism and urea clearance index in patients with SHP after maintenance hemodialysis

作　　者：刘委英 刘河建 魏自海 黄冠燕 Liu Wei-ying;Liu He-jian;Wei Zi-hai;Huang Guan-yan(Department of Pharmacy,Dayu People's Hospital,Ganzhou 341500,Jiangxi,China;Department of Nephrology,Dayu People's Hospital,Ganzhou 341500,Jiangxi,China)

机构地区：[1]大余县人民医院药剂科,江西赣州341500 [2]大余县人民医院肾内科,江西赣州341500

出　　处：《四川生理科学杂志》2024年第11期2582-2584,共3页

摘　　要：目的:探讨西那卡塞联合碳酸镧对维持性血液透析并继发性甲状旁腺功能亢进(Secondary hyperparathyroidism,SHP)患者钙磷代谢及尿素清除指数的影响。方法:选取2022年8月至2023年12月在本院诊治的72例维持性血液透析并SHP患者,采用随机数表法分为对照组(予以西那卡塞和骨化三醇软胶囊治疗,n=36)和观察组(在对照组基础上联合碳酸镧治疗,n=36),两组均持续治疗8 w,比较两组临床疗效,治疗前和治疗8 w后采用比色法检测钙磷代谢水平,超声检测甲状腺体积,采用放射免疫分析仪法检测血清指标;同时观察治疗期间不良反应发生情况。结果:观察组治疗有效率为97.22%,对照组为77.78%(P<0.05)。治疗8 w后两组血磷和钙磷乘积均降低(P<0.05),甲状腺体积减少,血清全段甲状旁腺激素(Intact parathyroid hormone,iPTH)降低,观察组均更显著(P<0.05)。观察组不良反应发生率为19.44%,对照组为11.11%(P>0.05)。结论:西那卡塞联合碳酸镧对维持性血液透析并SHP患者治疗效果较佳,且未见显著不良反应,具有一定安全性。Objective:To investigate the effect of cinacalcet combined with lanthanum carbonate on calcium and phosphorus metabolism and urea clearance index in patients with secondary hyperparathyroidism(SHP)undergoing maintenance hemodialysis.Methods:Atotal of 72 patients with maintenance hemodialysis and SHP who were treated in our hospital from August 2022 to December 2023 were selected and randomly divided into a control group(treated with cinacalcet and calcitriol soft capsules,n=36)and an observation group(treated with cinacalcet and lanthanum carbonate on the basis of the control group,n=36).Both groups were treated continuously for 8 weeks.The clinical efficacy of the two groups was compared.Before and after treatment for 8 weeks,the calcium and phosphorus metabolism levels were detected by colorimetry,the thyroid volume was detected by ultrasound,and the serum indicators were detected by radioimmunoassay.At the same time,the occurrence of adverse reactions during the treatment period was observed.Results:The effective rate of treatment in the observation group was 97.22%,while that in the control group was 77.78%(P<0.05).After 8 weeks of treatment,both groups showed a decrease in blood phosphorus and calcium-phosphate product(P<0.05),as well as a reduction in thyroid volume and serum intact parathyroid hormone(iPTH).The observation group showed a more significant decrease in all these parameters(P<0.05).The incidence of adverse reactions in the observation group was 19.44%,while that in the control group was 11.11%(P>0.05).Conclusion:The therapeutic effect of cinacalcet combined with lanthanum carbonate on patients with maintenance hemodialysis and SHP is better,and there is no significant adverse reaction,which is safe to a certain extent.

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 碳酸镧 钙磷代谢 

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