西那卡塞联合常规药物治疗血液透析继发性甲状旁腺功能亢进患者对疗效及钙磷代谢的影响

Effect of Sinacasse Combined with Conventional Drugs on the Efficacy and Calcium and Phosphorus Metabolism in the Treatment of Hemodialysis Patients with Secondary Hyperparathyroidism

目的探讨血液透析继发性甲状旁腺功能亢进患者采取西那卡塞联合常规药物治疗对疗效及钙磷代谢的影响。方法选取2019年2月-2022年2月我院收治的82例血液透析继发性甲状旁腺功能亢进患者,以随机数表法将其分为观察组(采用西那卡塞联合骨化三醇)和对照组(采用骨化三醇治疗),每组各41例。随访6个月,对比2组患者临床疗效,以及血钙、血磷水平,治疗前、治疗3个月后和治疗6个月后的血红蛋白水平、炎症因子水平,并统计两组药物不良反应发生情况。结果与对照组相比,观察组有效率较高(P<0.05)。与对照组相比,治疗6个月的血钙、血磷水平较低(P<0.05)。两组患者治疗3个月后、治疗6个月后的血红蛋白水平均高于治疗前(P<0.05),治疗6个月两组血红蛋白高于治疗3个月(P<0.05),与对照组相比,观察组治疗3、6个月后的血红蛋白水平较高(P<0.05),与治疗前相比,两组患者治疗后C反应蛋白、血清甲状旁腺激素和降钙素原降低(P<0.05),与对照组相比,C反应蛋白、血清甲状旁腺激素和降钙素原水平较低(P<0.05)。观察组和对照组不良反应发生率差异无统计学意义(P>0.05)。结论血液透析继发性甲状旁腺功能亢进患者采取西那卡塞联合常规药物治疗,临床效果显著,有利于降低患者的血钙、血磷水平,提高血红蛋白水平,缓解炎症且安全。

Objective:To investigate the effect of Sinacasse combined with conventional drugs on the efficacy and calcium and phosphorus metabolism in the treatment of hemodialysis patients with secondary hyperparathyroidism.Methods:A total of 82 hemodialysis patients with secondary hyperparathyroidism who were admitted to our hospital from February 2019 to February 2022 were selected as the research objects,and were randomly divided into the observation group(Sinacather combined with calcitriol)and the control group(calcitriol treatment),with 41 cases in each group.Follow up for 6 months,compare the clinical efficacy,blood calcium and phosphorus levels,hemoglobin levels and inflammatory factor levels before,after 3 months and 6 months of treatment of the two groups,and count the adverse drug reactions of the two groups.Results:There was significant difference in the effective rate between the two groups(P<0.05).The effective rate in the observation group was higher than that in the control group(P<0.05).The levels of blood calcium and phosphorus in the two groups were statistically significant(P<0.05).The levels of blood calcium and phosphorus in the observation group after 6 months of treatment were lower than those in the control group(P<0.05).There was statistically significant difference between the two groups of patients'hemoglobin levels through repeated measurement ANOVA(P<0.05).The hemoglobin levels of the two groups of patients after 3 months and 6 months of treatment were higher than those before treatment(P<0.05).The hemoglobin levels of the two groups of patients after 6 months of treatment were higher than those after 3 months of treatment(P<0.05).The hemoglobin levels of the patients in the observation group after 3 months and 6 months of treatment were higher than those in the control group(P<0.05).There was no significant difference in hemoglobin level between the two groups before treatment(P>0.05).There was no significant difference in the levels of C-reactive protein,serum parathyroid hormone and procalcitonin between the two groups before treatment(P>0.05).After 3 months of treatment,the levels of C-reactive protein,serum parathyroid hormone and calcitonin raw water in the two groups were lower than those before treatment(P<0.05),and the levels of C-reactive protein,serum parathyroid hormone and calcitonin raw water in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion:Sinacasse combined with calcitriol can improve the therapeutic effect of hemodialysis patients with secondary hyperparathyroidism,which is beneficial to the level of blood calcium and phosphorus,the level of hemoglobin,and the level of inflammatory factors,relieving inflammation and safe.