摘要
目的:探讨帕立骨化醇联合碳酸镧治疗维持性血液透析患者矿物质与骨代谢异常的效果。方法:选取复旦大学附属中山医院青浦分院2023年1月—2024年12月收治的维持性血液透析合并矿物质与骨代谢异常患者200例,采用随机数字表法分为对照组和观察组,各100例。两组均给予基础治疗,对照组在基础治疗基础上采用碳酸镧治疗,观察组在对照组基础上联合帕立骨化醇治疗。对比两组临床疗效,肾功能,尿蛋白指标,钙、磷、骨代谢指标。结果:观察组治疗总有效率高于对照组(P=0.030);治疗后,观察组估算肾小球滤过率水平高于对照组(P<0.001),血尿素氮、血清肌酐、β2微球蛋白水平低于对照组(P<0.05);治疗后,观察组尿微量白蛋白、24 h尿蛋白定量水平低于对照组(P<0.001);治疗后,观察组血磷、Ⅰ型前胶原氨基端前肽、全段甲状旁腺激素水平低于对照组(P<0.05),血钙水平高于对照组(P<0.001)。结论:帕立骨化醇联合碳酸镧治疗维持性血液透析患者矿物质与骨代谢异常的效果较好,可改善患者肾功能及尿蛋白水平,促进钙、磷、骨代谢指标恢复。
Objective:To explore the effect of paricalcitol combined with lanthanum carbonate in treatment of mineral and bone metabolism abnormalities in patients undergoing maintenance hemodialysis.Methods:A total of 200 patients who underwent maintenance hemodialysis and mineral and bone metabolism disorders and admitted to Qingpu Campus,Zhongshan Hospital,Fudan University from January 2023 to December 2024 were selected.They were divided into the control group and the observation group according to the random number table method,with 100 cases in each group.Both groups were given basic treatment.The control group was treated with lanthanum carbonate on the basis of basic treatment.The observation group was treated with paricalcitol on the basis of the control group.The clinical efficacy,renal function,urinary protein index,calcium,phosphorus,bone metabolism indexes were compared between the two groups.Results:The overall response rate of treatment in the observation group was higher than that in the control group(P=0.030).After treatment,the level of estimated glomerular filtration rate in the observation group was higher than that in the control group(P<0.001),and the levels of blood urea nitrogen,serum creatinine,andβ2 microglobulin in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of urinary microalbumin and 24-h urinary protein in the observation group were lower than those in the control group(P<0.001).After treatment,the levels of blood phosphorus,N-terminal propeptide of typeⅠprocollagen,and intact parathyroid hormone in the observation group were lower than those in the control group(P<0.05),and the level of blood calcium in the observation group was higher than that in the control group(P<0.001).Conclusion:Paricalcitol combined with lanthanum carbonate shows good effects in the treatment of mineral and bone metabolism disorders in maintenance hemodialysis patients,and can improve the renal function and urinary protein level of patients,and promote the recovery of calcium,phosphorus,and bone metabolism indexes.
作者
冯琳鸿
吴迪
王亚琨
朱迎春
Feng Linhong;Wu Di;Wang Yakun;Zhu Yingchun(Department of Nephrology,Qingpu Campus,Zhongshan Hospital,Fudan University,Shanghai 201700,China)
出处
《中外医药研究》
2025年第31期72-74,共3页
JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH
基金
上海市青浦区科学技术委员会软课题(编号:R2021-42)
上海市卫健委健康科普青年英才能力提升专项(编号:JKKPYC-2023-A19)。
关键词
碳酸镧
帕立骨化醇
矿物质代谢
骨代谢
维持性血液透析
Lanthanum carbonate
Paricalcitol
Mineral metabolism
Bone metabolism
Maintenance hemodialysis
