骨化三醇冲击联合树脂吸附治疗严重继发性甲状旁腺功能亢进症

Calcitriol pulse therapy combined with resin adsorption in treatment of severe secondary hyperparathyroidism

目的 探讨骨化三醇冲击联合树脂吸附治疗严重继发性甲状旁腺功能亢进症的疗效.方法 将32例血液透析患者采用随机数字表法分为骨化三醇冲击组（CP组）12例、骨化三醇冲击联合树脂吸附组（CP＋RA组）10例和树脂吸附组（RA组）10例.治疗前及治疗后1、2、3个月测定血清免疫反应性甲状旁腺素（iPTH）、白蛋白、尿素、肌酐和血红蛋白.每半个月测定血钙、磷.结果 每次树脂吸附后较吸附前iPTH明显下降（P〈0.05）.CP＋RA组治疗后2个月iPTH水平较治疗前明显下降,治疗后3个月,CP＋RA组iPTH水平为（598.50±317.45）ne/L,明显低于CP组的（1008.67±436.85）ng/L和RA组的（1464.60±411.27）ng/L （P〈0.05）.结论 骨化三醇冲击联合树脂吸附能有效降低严重继发性甲状旁腺功能亢进症患者的iPTH水平.

Objective To investigate the effects of oral calcitriol pulse therapy combined with resin adsorption in treatment of severe secondary hyperparathyroidism.Methods Thirty-two hemodialysis patinents were randomly divided into three groups：oral calcitriol pulse therapy（CP group,12 cases）,oral calcitriol pulse therapy combined with resin adsorption group（CP＋RA group,10 cases）,and resin adsorption group（RA group,10 cases）.Serum immunoreactive parathyroid hormone（iPTH）,albumin,urea,creatinine,hemoglobin levels were detected before treatment and 1,2,3 months after treatment respectively.Serum calcium and phosphorus levels were also detected every half a month.Results The clearance rate of resin adsorption Was decreased significantly every time（P〈0.05）.Serum iPTH in CP＋RA group decreased significantly 2 months after treatment.Serum iPTH3 months after treatment in CP＋RA group[（598.50 ±317.45）ng/L]was less than that in CP group[（1008.67±436.85）ng/L]and RA group[（1464.60±411.27）ns/L]（P〈0.05）.Conclusion Oral calcitriol pulse therapy combined with resin adsorption can clear iPTH safely and effectively.