摘要
【目的】探讨骨化三醇治疗慢性肾病非透析患者继发性甲状旁腺功能亢进的疗效。【方法】以本院收治的37例合并继发性甲状旁腺功能亢进的慢性肾病非透析患者作为研究对象，根据患者血清全段甲状旁腺激素（iPTH）水平确定骨化三醇[1，25-（OH）2-D3]的给药剂量，对所有患者治疗前及治疗后第4、8和12周时的血钙（Ca）、血磷（P），钙磷乘积（Ca＆#215;P）及血清iPTH水平进行监测，同时观察其不良反应发生情况。【结果】所有患者均顺利完成治疗及随访，无一例发生明显副反应。经治疗后，10例骨痛患者有8例骨痛消失，另2例骨痛改善不明显，6例皮肤瘙痒患者症状全部消失。血iPTH水平在治疗后4周、8周和12周呈持续下降趋势，与治疗前比较，差异均有统计学意义（P＜0．05）；而血Ca、血P和Ca＆#215;P与治疗前比较差异均无统计学意义（P＞0．05）。【结论】骨化三醇治疗慢性肾病非透析患者继发性甲状旁腺功能亢进疗效显著，不良反应轻，安全可靠。
[Objective] To explore the efficacy of calcitriol for the treatment of non-dialysis chronic kidney disease pa-tients with secondary hyperparathyroidism .[Methods] Totally 37 cases of chronic kidney disease with secondary hyper-parathyroidism in our hospital were taken as research subjects .According to serum immunoreactive parathyroid hormone （iPTH） of patients ,the dosage of calcitriol[1 ,25-（OH）2-D3 ] was determined .Serum calcium（Ca） ,phosphorus（P） ,cal-cium-phosphorus product（Ca ＆#215; P） and iPTH levels before and 4 ,8 and 12 weeks after treatment were monitored .The ad-verse reactions were observed .[Results] All patients successfully finished the treatment and follow-up .No obvious ad-verse reaction occurred .Among 10 patients with bone pain ,the symptoms of 8 patients after treatment disappeared ,while those of other 2 patients were not improved obviously .All symptoms of 6 patients with itch of skin disappeared .Serum iPT H at 4 ,8 and 12 weeks after treatment showed a declining trend ,and there was significant difference between before and after treatment（ P〈0 .05） .But there was no significant difference in blood Ca ,P and Ca ＆#215; P between before and af-ter treatment（ P〉0 .05） .[Conclusion] Calcitriol for the treatment of non-dialysis chronic kidney disease patients with secondary hyperparathyroidism has significant efficacy with little adverse reactions ,so it is safe and reliable .
出处
《医学临床研究》
CAS
2014年第2期345-347,共3页
Journal of Clinical Research
