鲑鱼降钙素对肾性骨病并继发性甲旁亢患者的作用观察

An effective observation of salmon calcitonin on patients with renal osteodystrophy and secondary hyperparathyroidism

目的:观察鲑鱼降钙素皮下注射对肾性骨病并继发性甲旁亢患者的作用。方法:选择合并有继发性甲状旁腺机能亢进的65例肾性骨病患者为研究对象,采用简单随机的方法分组,治疗组给予鲑鱼降钙素治疗,对照组给予活性维生素D治疗,用药前和用药4、8、12周分别进行视觉模拟疼痛评分和血钙、血磷和血甲状旁腺素(PTH)检测,并进行统计学分析。结果:治疗组入组33例,对照组入组32例,应用鲑鱼降钙素后,治疗组甲状旁腺素、血磷和血钙明显降低,与对照组比较差异有统计学意义(P<0.05);患者骨关节疼痛等症状均有不同程度缓解,与对照组比较差异有统计学意义(P<0.05);但已发生的转移性钙化等现象无变化。结论:鲑鱼降钙素治疗肾性骨病并继发性甲旁亢时,可以缓解骨关节疼痛症状,并能够有效降低高甲状旁腺素、高血磷和高血钙,值得进一步观察和探讨。

AIM： To study the effect of salmon calcitonin （Miacalcic） in treatment of renal osteodystrophy and secondary hyperparathyroidism in patients undergoing tong-term hemodialysis （HD） or hemodiafiltration （HDF）. METHODS： A total of 65 patients with renal osteodystrophy and secondary hyperparathyroidism were randomly assigned to receive either Miacalcic or calcitriol. All patients were treated with HD or HDF. The visual analog scale management of pain （VAS） and levels of serum calcium and phosphorus, parathyroid hormone （PTH） were monitored during 0, 4, 8, 12 weeks of treatment. RESULTS： 33 and 32 patients were randomly assigned to Miacalcic group and control group. In Miacalcic group, the levels of serum calcium, phosphorus and PTH were more effectively decreased than those of control group. At the same time, the symptoms of renal osteodystrophy, such as bone pain and joint dysfunction were more significantly improved than those of control group. There were significant difference between Miacalcic group and control group（ P 〈 0.05 ）. But there were no contribution to occurrenced metastatic calcification. CONCLUSION： In treatment of renal osteodystrophy and secondary hyperparathyroidism, Miacalcic can alleviate bone pain symptom and reduce the high PTH, high serum phosphorus and high serum calcium effectively, is remarkably efficacious and worthiness of advanced exploration.