骨化三醇不同口服方法对63例维持性血液透析患者的临床影响探讨

Effect of Different Oral Calcitriol Method in 63 Patients with Hemodialysis

目的 探讨口服骨化三醇对维持性血液透析患者的矿物质和骨代谢异常的影响.方法 将我院行维持性血液透析治疗6个月以上,且血清全段甲状旁腺激素（IPTH）水平300 ～ 600 pg/mL63例患者,随机分为空白对照组、每日口服组、骨化三醇冲击治疗组.观察8周,比较骨化三醇治疗前后IPTH、血清钙、钙磷乘积、碱性磷酸酶（ALP）、颈动脉内膜厚度等相关因素的变化情况.结果 F检验结果显示,3组患者ALP、颈动脉内膜厚度和IPTH指标不完全一致（P＜0.05,拒绝H0假设,接收H1假设）,而血清内钙磷含量差异无统计学意义（P＞0.05）.LSD法两两比较结果显示,ALP含量指标3组患者差异具有统计学意义,并且骨化三醇冲击治疗组＜每日口服组＜空白对照组;颈动脉内膜厚度和IPTH指标也具有类似规律.结论 口服骨化三醇对治疗维持性血液透析患者矿物质和骨代谢异常治疗有效,尤其是口服冲击治疗取得满意临床效果.

Objective To investigate the effect of oral calcitriol on mineral and bone - metabolism disorder in patients with mainte- nance hemodialysis patients. Methods 63 patients with intact parathyroid hormone （IPTH） 300 - 600pg/ml and maintenance hemodialysis for more than 6 months were randomly divided into blank control group （without taking ossification in three alcohol）, daily oral group （oral daily ossification in three alcohol 0.5μg） and bone three alcohol shock treatment group （ weekly administration of ossification in three alco- hol for 2 times, each time 1.5μg）. After observation of 8 weeks, IPTH three alcohol ossification, serum calcium, calcium phosphorus product, alkaline phosphatase （ALP） and changes of carotid artery intima - media thickness were compared. Results F test results showed, ALP, carotid intima - media thickness and the IPTH index in three groups were not entirely consistent （ P 〈 0.05, rejecting the H0 hypothesis and receiving the H 1 hypothesis）, but there was no significant difference in serum calcium and phosphorus content （P 〉 0.05 ）. The comparison of LSD showed that, there was statistical significance in ALP content index among three groups, and treatment group 〈 oral group 〈 blank control group; carotid intima - media thickness and IPTH index had a similar law. Conclusion Oral calcitiol has effect on mineral and bone - metabolism disorder in patients with maintenance hemodialysis patients, especially there is satisfactory clinical effect on oral treatment.