碳酸镧联合司维拉姆治疗肾功能不全失代偿期高磷血症的临床效果  

Clinical Efficacy of Lanthanum Carbonate Combined with Sevelamer in Treating Hyperphosphatemia in Decompensated Renal Insufficiency

作　　者：陈佩雷 Chen Peilei(Yueqing People's Hospital,Yueqing 325600,Zhejiang Province,China)

机构地区：[1]乐清市人民医院,浙江乐清325600

出　　处：《中外医药研究》2025年第5期18-20,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

基　　金：乐清市医药卫生科学研究项目(编号:2023R19)。

摘　　要：目的:研究碳酸镧联合司维拉姆治疗肾功能不全失代偿期高磷血症的临床效果。方法:选取2021年7月—2024年3月乐清市人民医院接诊的肾功能不全失代偿期高磷血症患者160例,随机分为对照组、研究组,每组80例。对照组行碳酸镧咀嚼片治疗,研究组行碳酸镧咀嚼片联合碳酸司维拉姆片治疗。比较两组钙磷代谢、炎性因子、肾功能、心血管钙化程度、不良反应情况。结果:治疗3个月后,两组血钙水平升高,血磷、钙磷乘积水平降低,研究组血钙、血磷及钙磷乘积水平低于对照组(P<0.05);治疗3个月后,两组C反应蛋白、白细胞介素-6、降钙素原、血尿素氮、血肌酐水平降低,研究组低于对照组(P<0.05);治疗3个月后,两组冠状动脉钙化积分降低,研究组低于对照组(P<0.05);研究组冠状动脉钙化发生率低于对照组(P<0.05);两组不良反应发生率对比,无统计学差异(P>0.05)。结论:碳酸镧咀嚼片、碳酸司维拉姆片联合治疗可有效纠正肾功能不全失代偿期高磷血症患者的钙磷代谢水平,控制炎症及肾功能损伤,降低冠状动脉钙化风险,安全性好。Objective:To investigate the clinical efficacy of lanthanum carbonate combined with sevelamer in treating hyperphosphatemia in decompensated renal insufficiency.Methods:A total of 160 patients with hyperphosphatemia in decompensated renal insufficiency admitted to Yueqing People's Hospital from July 2021 to March 2024 were selected and randomly divided into a control group and a study group,with 80 cases in each group.The control group was treated with lanthanum carbonate chewable tablets,while the study group was treated with lanthanum carbonate chewable tablets combined with sevelamer carbonate tablets.The calcium-phosphorus metabolism,inflammatory factors,renal function,cardiovascular calcification,and adverse reactions were compared between the two groups.Results:After 3 months of treatment,serum calcium levels increased,and serum phosphorus and calcium-phosphorus product levels decreased in both groups,with the study group showing lower levels than the control group(P<0.05).After 3 months of treatment,levels of C-reactive protein,interleukin-6,procalcitonin,blood urea nitrogen,and serum creatinine decreased in both groups,with the study group showing lower levels than the control group(P<0.05).After 3 months of treatment,coronary artery calcification scores decreased in both groups,with the study group showing lower scores than the control group(P<0.05).The incidence of coronary artery calcification was lower in the study group than in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The combination of lanthanum carbonate chewable tablets and sevelamer carbonate tablets effectively corrects calcium-phosphorus metabolism,controls inflammation and renal function damage,reduces the risk of coronary artery calcification,and demonstrates good safety in patients with hyperphosphatemia in decompensated renal insufficiency.

关 键 词：肾功能不全 高磷血症 碳酸镧 司维拉姆 冠状动脉钙化 

分 类 号：R692[医药卫生—泌尿科学] R589.1[医药卫生—外科学]