碳酸镧对维持性血液透析患者并继发性甲旁亢的高血磷影响

Effect of lanthanum carbonate on hyperphosphatemia in maintance hemodialysis patients with secondary hyperparathyroidism

目的观察碳酸镧对维持性血液透析患者并继发性甲旁亢的高磷血症的影响。方法将31例血清全段甲状旁腺素(iPTH)300-500pg/ml的维持性血液透析患者随机分为2组,每组均口服骨化三醇1.0ug,2次/周冲击治疗。观察组给予口服碳酸镧咀嚼片(Fosrenol)500mg,3次/d,14例。对照组给予醋酸钙片667mg,3次/d,17例。结果治疗8周后观察组血磷及iPTH较治疗前明显下降,血磷较对照组有明显下降,差异有统计学意义(P<0.05)。结论碳酸镧可有效降低MHD患者并继发性甲旁亢用骨化三醇冲击治疗时的血磷水平。

Objective To explore the effect of lanthanum carbonate （Fosrenol） on hyperphosphatemia in maintance he- modialysis（MHD） patients with secondary hyperparathyroidism（SHPT） treated by calcitriol pulse theraphy. Methods Thirty- one MHD patients, with intact parathormone （iPTH） levels of 300 -500pg/ml, were treated with calcitriol （1.0 ug,biw）. 14 of the patients （the observation group） were treated with oral lanthanum carbonate （Fosrenol） （ 500mg, tid）, and 17 of the patients （ the control group ） were treated with oral calcium acetate （ 667 rag, rid）. Serum phos- phate, calcium and iPTH were examined with 8 weeks of therapy. Results Serum phosphate, calcium and iPTH levels 8 weeks after treatment in the observation group were significantly lower than those before treatement. The levels of serum phosphate in the observation group were significantly lower than those in the control group （ P 〈 0. 05 ）. Conclusion Lanthanum carbonate as approach for decreasing the hyperphosphsopatemia with SHPT using calcitriol pulse therapy.