钙通道阻滞剂对尿毒症患者血浆甲状旁腺素和钙磷代谢的影响

Effect of calcium channel blocker on plasma PTH and Ca^2＋ ,P^3- metabolism in uremic patients

目的观察钙通道阻滞剂对尿毒症患者血甲状旁腺激素（PTH）和钙磷代谢的影响。方法选择本院血液透析患者共128例。根据用药情况分为4组：对照组、钙通道阻滞剂组、活性维生素D制剂组、钙通道阻滞剂＋活性维生素D制剂组。所有患者每个月常规检测透析前静脉血PTH，血清钙（Ca^2＋）、磷（P^3-）等。结果钙通道阻滞剂能促使甲状旁腺异常分泌PTH，与活性维生素D制剂合用则降低活性维生素D制剂抑制PTH分泌的效果，同时有引起高钙血症的可能。结论对肾衰竭患者使用钙通道阻滞剂不但能促使甲状旁腺分泌PTH，而且有致高钙血症危险。

Objective To investigate the effect of calcium channel blocker on PTH and Ca^2 , P^3- metabolism in uremic patients. Method 128 patients undergoing maintenance hemodialysis were divided into four groups regarding of their medication ① control group ,② group of calcium channel blocker ③ calcitriol group ④ group of calcium channel blocker and calcitriol. The blood level of PTH, Ca^2＋ , P^3- etc were measured every month. Results Calcium channel blocker promoted parathyrin secretion abnormally and decreased the effect of calcitriol. Conclusions Calcium channel blocker when used in uremic patients can promote Parathyroid secretion of PTH abnormally and increase the risk of hypercalcemia.