骨化三醇口服治疗血液透析病人继发性甲状旁腺功能亢进

Calcitriol therapy in hemodialysis patients for treatment of secondary hyperarathyroidism

目的：观察骨化三醇口服治疗血液透析病人继发性甲状旁腺功能亢进（ＳＨＰＴ）的疗效。方法：４５例维持性血透病人中，１９例用小剂量骨化三醇（２μｇ×２次／ｗｋ）口服治疗，１１例用大剂量骨化三醇（４μｇ×２次／ｗｋ）口服治疗，１５例用骨化三醇０．２５μｇ／ｄ的常规小剂量治疗，疗程１６ｗｋ。结果：骨化三醇口服治疗后，ＳＨＰＴ明显降低（Ｐ＜０．０５，０．０１），骨密度明显增高（Ｐ＜０．０１），常规小剂量治疗病人中的ＳＨＰＴ值及骨密度则无显著变化（Ｐ＞０．０５）。结论：大剂量和小剂量骨化三醇口服治疗效果均优于常规小剂量治疗，其中大剂量比小剂量疗效好。

AIM: To study the effect of oral calcitriol therapy for secondary hyperparathyroidism in hemodialysis patients. METHODS: Among 45 patients under hemodialysis, we treated 19 cases with oral calcitriol 2 μg twice per wk, 11 cases with 4 μg twice per wk, and 15 cases with 0.25 μg per day. The treatment lasted 16 wk. RESULTS: In calcitriol 2 or 4 μg groups, the level of high sensitive parathyroid hormon (HS-PTH) in serum was decreased (P<0.05, 0.01), and the bone density was increased (P<0.01). In calcitriol 0.25 μg/d group, HS-PTH and bone density were not much changed (P>0.05). CONCLUSION: Calcitriol of large dose is more effective than that of the low dose.