阿法骨化醇与西那卡塞联合用药在血液透析继发性甲亢患者的疗效

Efficacy of Alfacalcidol Combined with Sinacase in Hemodialysis Patients with Secondary Hyperthyroidism

目的 探讨阿法骨化醇与西那卡塞联合用药治疗血液透析继发性甲亢患者的疗效。方法 选取2019年6月-2021年6月我院收治的60例血液透析继发性甲亢患者进行对照研究,将其随机分为观察组和对照组,每组各30例。对照组口服西那卡塞片,观察组在上述方案基础上加用阿法骨化醇片。比较两组血红蛋白(Hb)、红细胞计数(RBC)、红细胞压积(HCT)、促甲状腺素(TSH)、全段甲状旁腺激素(PTH)、血钙(Ca)、血磷(P)水平、不良反应。结果 组间对比两组HCT水平未显示明显差异(P>0.05);两组治疗后Hb、RBC水平呈上升趋势且观察组水平更高(P<0.05)。两组治疗后TSH、Ca水平呈现上升趋势且观察组更高,PTH、P水平呈现下降趋势且观察组更低(P<0.05)。两组不良反应发生率分别为16.67%、10.00%,无明显差异(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亢患者可改善血细胞水平,纠正甲状腺激素表达和钙磷指标代谢,具有较高的安全性,值得临床应用。

Objective: To explore the efficacy of alfacalcidol combined with Sinacase in the treatment of patients with secondary hyperthyroidism. Methods: 60 hemodialysis patients with secondary hyperthyroidism in our hospital were enrolled from June 2019 to June 2021, which were randomly divided into observation group and control group, with30 cases in each group. The control group was given Sinacase tablets orally, while the observation group was given alfacalcidol tablets in addition to the above scheme. The levels of hemoglobin(Hb), red blood cell count(RBC), hematocrit(HCT), thyrotropin(TSH), whole parathyroid hormone(PTH), blood calcium(Ca), blood phosphorus(P) and adverse reactions were compared between the two groups. Results: There was no significant difference in HCT level between the two groups(P>0.05). After treatment, the levels of Hb and RBC in the two groups showed an upward trend, and those in the observation group were higher(P<0.05). After treatment, the levels of TSH and Ca in the two groups showed an upward trend and had higher level in the observation group, while the levels of PTH and P showed a downward trend and had lower level in the observation group(P<0.05). The incidence of adverse reactions in the two groups were 16.67% and10.00% respectively, with no significant difference(P>0.05). Conclusion: Alfacalcidol combined with Sinacase can improve blood cell level, correct thyroid hormone expression, and calcium and phosphorus metabolism in hemodialysis patients with secondary hyperthyroidism, which is safe and should be paid attention to clinically.