西那卡塞治疗肾移植术后三发性甲状旁腺功能亢进的临床疗效及安全性研究  

Clinical efficacy and safety of cinacalcet in the treatment of tertiary hyperparathyroidism after renal transplantation

作　　者：相华 常帅 郑海燕 徐晓琴 荣景 Xiang Hua;Chang Shuai;Zheng Haiyan;Xu Xiaoqin;Rong Jing(Department of Nephrology,Xinjiang 474 Hospital,Urumqi 830011,China)

机构地区：[1]新疆四七四医院肾病内科,新疆乌鲁木齐830011

出　　处：《实用药物与临床》2024年第12期894-898,共5页Practical Pharmacy and Clinical Remedies

基　　金：乌鲁木齐市卫生健康委科技计划项目(202145)。

摘　　要：目的 观察西那卡塞治疗肾移植术后三发性甲状旁腺功能亢进(Tertiary hyperparathyroidism,THPT)的疗效和安全性。方法 纳入在2011年6月至2022年6月于新疆四七四医院就诊且符合研究条件的患者82例,按治疗方式将患者分为西那卡塞组和对照组;收集入组患者的一般情况、THPT治疗前相关血清指标[全段甲状旁腺激素(iPTH)、血钙、血磷和血肌酐]、骨密度和临床症状评分[视觉模拟评分法(VAS)评分]等基线资料;收集两组患者治疗后1、6和12个月的相关血清学指标、骨密度、临床症状评分和并发症资料,并进行组内和组间比较。结果 对照组中4例出现病情进展;西那卡塞组有效率显著高于对照组(85.71%vs. 27.50%,P<0.05);与治疗前相比,西那卡塞组在治疗12个月时,血iPTH[(119.19±53.18) pg/ml vs.(294.05±99.34) pg/ml]、血钙[(2.41±0.22)mmol/L vs.(2.79±0.30) mmol/L]、骨密度[-2.05(-1.70,-2.60)vs.-2.80(-1.50,-4.00)]和VAS评分[8.00(7.00,9.00)vs. 5.00(4.00,6.00)]方面差异有统计学意义(P<0.05);在治疗12个月时,与对照组相比,西那卡塞组在血iPTH[(119.19±53.18) pg/ml vs.(250.39±116.23) pg/ml]、血钙[(2.41±0.22) mmol/L vs.(2.73±0.11) mmol/L]、骨密度[-2.05(-1.70,-2.60)vs.-2.60(-2.13,-3.43)]和VAS评分[8.00(7.00,9.00)vs. 6.00(5.00,6.75)]方面差异有统计学意义(P<0.05);西那卡塞组共20人次存在并发症,经对症治疗后好转。结论 西那卡塞是治疗肾移植术后THPT的有效手段,当医院不具备外科治疗条件、患者有外科治疗禁忌证或患者拒绝行外科治疗时,西那卡塞是重要的保守治疗手段。Objective To explore the efficacy and safety of cinacalcet in the treatment of tertiary hyperparathyroidism(THPT)after renal transplantation.Methods A total of 82 eligible patients who received treatment in Xinjiang 474 Hospital from June 2011 to June 2022 were included and divided into the cinacalcet group and the control group according to the treatment methods.The baseline data including general characteristics,pre-treatment serum markers[Intact parathyroid hormone(iPTH),calcium,phosphorus,and creatinine],bone density,and clinical symptom scores(VAS scores)of the patients was collected.The data on relevant serological markers,bone density,clinical symptom scores,and complications at 1,6,and 12 months after treatment of the patients was collected,and the relevant indicators within and between groups were compared.Results In the control group,4 patients had disease progression.The effective rate of cinacalcet group was significantly higher than that of control group(85.71%vs.27.50%,P<0.05).At 12 months of treatment,compared with before treatment,cinacalcet group showed significant differences in serum iPTH[(119.19±53.18)pg/ml vs.(294.05±99.34)pg/ml],serum calcium[(2.41±0.22)mmol/L vs.(2.79±0.30)mmol/L],bone mineral density[-2.05(-1.70,-2.60)vs.-2.80(-1.50,-4.00)]and symptom score[8.00(7.00,9.00)vs.5.00(4.00,6.00)](P<0.05).At 12 months of treatment,compared with the control group,cinacalcet group showed significant difference in serum iPTH[(119.19±53.18)pg/ml vs.(250.39±116.23)pg/ml],serum calcium[(2.41±0.22)mmol/L vs.(2.73±0.11)mmol/L],bone mineral density[-2.05(-1.70,-2.60)vs.-2.60(-2.13,-3.43)]and VAS score[8.00(7.00,9.00)vs.6.00(5.00,6.75)](P<0.05).A total of 20 cases in cinacalcet group had complications,which improved after symptomatic treatments.Conclusion Cinacalcet is an effective treatment for THPT after renal transplantation.When hospital do not have the conditions for surgical treatment,patients have contraindications for surgical treatment,or patients refuse to undergo surgical treatment,cina

关 键 词：肾移植 三发性甲状旁腺功能亢进 西那卡塞 全段甲状旁腺激素 肾功能 

分 类 号：R582.1[医药卫生—内分泌] R699.2[医药卫生—内科学]