摘要
目的探究阿法骨化醇联合西那卡塞治疗血液透析继发性甲状旁腺功能亢进症的临床疗效及对患者血磷、血钙、甲状旁腺素(parathyroid hormone,PTH)水平的影响。方法选取维持性血液透析继发性甲状旁腺功能亢进症患者78例,用随机数字表法分为对照组和观察组,每组39例。2组患者均给予阿法骨化醇治疗,观察组加用西那卡塞,持续3个月。比较治疗前、后患者血钙、血磷、PTH、碱性磷酸酶(alkaline phosphatase,ALP)和甲状旁腺体积的变化,并记录治疗过程中不良反应的发生情况。结果治疗3个月后,观察组的治疗有效率(89.75%)显著高于对照组(71.79%)(P<0.05);2组患者的血钙水平较治疗前均升高,且观察组低于对照组(P<0.05);2组患者的血磷水平较治疗前均降低,且观察组低于对照组(P<0.05);2组患者的PTH和ALP水平较治疗前均降低,且观察组低于对照组(P<0.05);2组患者甲状旁腺的长、宽、厚和体积较治疗前均减小,且观察组小于对照组(P<0.05)。观察组不良反应的发生率(10.26%)低于对照组(30.77%)(P<0.05)。结论阿法骨化醇联合西那卡塞治疗血液透析继发性甲状旁腺功能亢进疗效显著,可有效改善患者的血钙、血磷、ALP和PTH水平,同时降低不良反应的发生率。
Objective To explore the clinical curative effect of alfacalcidol combined with cinacalcet in patients with secondary hyperparathyroidism(SHPT)undergoing hemodialysis and its influences on the levels of blood phosphorus,calcium and parathyroid hormone(PTH).Methods A total of 78 maintenance hemodialysis(MHD)patients with SHPT were enrolled,and divided into control group and the observation group according to random number table method,39 cases in each group.The both groups were treated with alfacalcidol,and observation group was additionally treated with cinacalcet for 3 months.The changes of blood cal-cium,blood phosphorus,PTH,alkaline phosphatase(ALP)and parathyroid volume before and after treatment were compared between the 2 groups.The occurrence of adverse reactions during treatment was recorded.Results After 3 months of treatment,the response rate of treatment in observation group was significantly higher than that in control group(89.75%vs.71.79%,P<0.05).After treatment,the level of blood calcium in both groups was increased,which was lower in observation group than in control group.After treatment,the level of blood phosphorus in both groups was decreased,which was lower in observation group than in control group(P<0.05).After treatment,the levels of PTH and ALP in both groups were decreased,which were lower in observation group than in control group(P<0.05).After treatment,the length,width,thickness and volume of parathyroid glands in both groups were decreased,which were lower in observation group than in control group(P<0.05).The incidence of adverse reactions was significantly lower in observation group than in control group(10.26%vs.30.77%,P<0.05).Conclusion The curative effect of alfacalcidol combined with cinacalcet is significant in MHD patients with SHPT,which can effectively improve the levels of blood calcium,phosphorus,ALP and PTH,and reduce the incidence of adverse reactions.
作者
朱丹
刘胜阳
张宝桐
张绎平
ZHU Dan;LIU Shengyang;ZHANG Baotong;ZHANG Yiping(Dialysis Room,Liaoyang Central Hospital,Liaoyang 111000,China)
出处
《西北药学杂志》
CAS
2023年第5期125-129,共5页
Northwest Pharmaceutical Journal
基金
辽宁省医学科技计划项目(编号:LHGJ20191704)。
