阿法骨化醇治疗继发性甲状旁腺功能亢进疗效观察

Effect of alfacalcidol administration in secondary hyperparathyroidism

目的观察和比较阿法骨化醇冲击和每日治疗尿毒症患者继发性甲状旁腺功能亢进的疗效。方法将30例维持血液透析的继发性甲旁亢患者随机分为2组,第1组口服阿法骨化醇0.5ug,每日1次;第2组1ug,隔日1次。治疗前及治疗后每月查iPTH,每两周查Ca,AKP,P。共观察4月。结果每日组在治疗后第1、2月iPTH下降不明显,与治疗前比较,差异无显著性意义(P>0.05),第4月iPTH下降明显,与治疗前比较,差异有显著性意义(P<0.05);冲击组在治疗第1、2、4月iPTH均下降明显,与治疗前比较,差异有显著性意义(P<0.05);两组间比较差异有显著性意义(P<0.05)。两组的血钙、血磷在治疗前后差异均无显著性意义(P>0.05)。两组血碱性磷酸酶在治疗前后比较,差异有显著性意义(P<0.05)。结论阿法骨化醇口服冲击和每日治疗均能控制继发性甲旁亢,冲击组疗效更明显且起效快。

Objective To investigate and contrast the efficacy of oral impact versus daily alfacalcidol therapy on secondary hyperparathyroidism in urinaemia patients. Methods Thirty maintenance hemodialysis patients were randomly divided into two groups and received either impact （2ug every two days） or daily （0.5ug every day） oral alfacalcidol in a 4-month course. Levels of serum iPTH, calcium, phosphorus and alkaline phosphatase were tested before and during the study period. Results iPTH level were observed no significant difference in daily group during the first and the second month （P〉0.05）, while significantly lower in the forth month （P〈0.05）. Significant difference were observed in impact group during each month. （P〈0.05）, and there were significant difference between the two groups（P〈0.05）. Serum calcium and phosphorus were remained unchanged （P〉0.05）. Alkaline phosphatase level were observed significant difference in either daily group or impact group （P〈 0.05）. Conclusions Alfacalcidol exerts therapeutic effect on secondary hyperparathyroidism. The efficacy of impact therapy are faster and better than those of daily therapy.