西那卡塞联合碳酸司维拉姆治疗血液透析并发SHPT患者的临床效果  

Clinical effect of cinacalcet combined with sevelamer carbonate in the treatment of hemodialysis patients with SHPT

作　　者：邓莹[1] 郭晓超 DENG Ying;GUO Xiaochao(Nephrology Department,Hanzhong Central Hospital,Hanzhong 723000,China)

机构地区：[1]汉中市中心医院肾内科,陕西汉中723000

出　　处：《临床医学研究与实践》2024年第32期47-50,共4页Clinical Research and Practice

摘　　要：目的探讨西那卡塞联合碳酸司维拉姆治疗血液透析并发继发性甲状旁腺功能亢进症(SHPT)患者的临床效果。方法选取2019年12月至2022年12月汉中市中心医院肾内科收治的100例血液透析并发SHPT患者为研究对象,采用随机数字表法将其分为对照组与联用组,各50例。对照组使用碳酸司维拉姆治疗,联用组使用西那卡塞联合碳酸司维拉姆治疗。比较两组的治疗效果。结果治疗后,联用组的血钙、血磷及全段甲状旁腺激素(iPTH)达标率高于对照组(P<0.05)。治疗后,两组的碱性磷酸酶(AKP)水平、钙磷乘积均显著降低,且联用组低于对照组(P<0.05)。治疗后,两组的甲状旁腺长度、宽度、厚度及体积均显著减小,且联用组小于对照组(P<0.05)。联用组的治疗总有效率高于对照组(P<0.05)。药物治疗期间,联用组的非致死性心血管不良事件发生率低于对照组(P<0.05)。结论西那卡塞联合碳酸司维拉姆治疗血液透析并发SHPT患者的临床效果较好,可有效保持钙磷代谢平衡、改善iPTH水平、缩小甲状旁腺体积以及降低心血管不良事件发生率,有利于患者的长期生存。Objective To investigate the clinical effect of cinacalcet combined with sevelamer carbonate in the treatment of hemodialysis patients with secondary hyperparathyroidism(SHPT).Methods A total of 100 hemodialysis patients with SHPT admitted in the nephrology department of Hanzhong Central Hospital from December 2019 to December 2022 were selected as the research objects.The patients were divided into control group and combined group by random number table method,with 50 cases in each group.The control group was treated with sevelamer carbonate,and the combined group was treated with cinacalcet combined with sevelamer carbonate.The therapeutic effects of the two groups were compared.Results After treatment,the compliance rates of blood calcium,blood phosphorus and intact parathyroid hormone(iPTH)in the combined group were higher than those in the control group(P<0.05).After treatment,the levels of alkaline phosphatase(AKP)and calcium-phosphorus product in the two groups significantly decreased,and those in the combined group were lower than the control group(P<0.05).After treatment,the length,width,thickness and volume of parathyroid glands in the two groups significantly reduced,and those in the combined group were smaller than the control group(P<0.05).The total effective rate of treatment of the combined group was higher than that of the control group(P<0.05).During drug treatment,the incidence of non-fatal cardiovascular adverse events in the combined group was lower than that in the control group(P<0.05).Conclusion Cinacalcet combined with sevelamer carbonate has a good clinical effect in the treatment of hemodialysis patients with SHPT,it can effectively maintain the balance of calcium and phosphorus metabolism,improve iPTH level,reduce parathyroid volume and decrease the incidence of cardiovascular adverse events,it is beneficial to the long-term survival of patients.

关 键 词：继发性甲状旁腺功能亢进症 血液透析 西那卡塞 碳酸司维拉姆 甲状旁腺体积 

分 类 号：R581.1[医药卫生—内分泌]