碳酸镧对骨化三醇冲击治疗慢性肾衰竭持续非卧床腹膜透析继发性甲状旁腺功能亢进患者血钙、血磷影响的研究

Ef ects of Lanthanum Carbonate on Serum Calcium and Phosphorus of CAPD Patients with Chronic Renal Failure Receiving Calcitriol Pulse h erapy Due to Secondary Hyperparathyroidism

目的探讨碳酸制在慢性肾衰竭持续非卧床腹膜透析（CAPD）患者应用骨化三醇治疗继发性甲状旁腺功能亢进（SHPT）时对血钙和血磷的影响。方法将2013年3～6月青岛市市立医院东院腹膜透析中心的CAPD导致SHPT的患者随机分为两组。碳酸镧组予以口服碳酸镧和骨化三醇冲击治疗，碳酸钙组给予碳酸钙和骨化三醇治疗，观察患者血清钙、磷、iPTH的变化。统计分析采用SPSS17．0软件。结果共纳入40例患者，两组各20例。治疗12周后，碳酸镧组患者血磷（t=5．095，P=0．000）和iPTH（t=1．225，P=0．000）水平均明显下降，且碳酸镧组血钙（t=1．127，P=0．001）、血磷（t=2．035，P=0．000）水平明显低于碳酸钙组。结论碳酸镧能有效治疗CAPD患者应用骨化三醇冲击治疗SHPT时的高钙血症和高磷血症。

Objective To explore and discuss the effects of lanthanum carbonate on serum calcium and phosphorus of continuous ambulatory peritoneal dialysis （CAPD） patients with chronic renal failure receiving calcitriol pulse therapy due to secondary hyperparathyroidism （SHPT）. Methods CAPD patients caused by SHPT in peritoneal dialysis centre of the Qingdao Municipal Hospital of Eastern Hospital from March to June, 2013 were selected and randomly divided into two groups （lanthanum carbonate group and calcium carbonate group）. The lanthanum carbonate group were treated with oral lanthanum carbonate and calcitriol pulse therapy, while the calcium carbonate group were treated with calcium carbonate and calcitriol. Change of levels of serum calcium, phosphorus and iPTH were observed and statistic analysis was conducted using SPSS 17.0. Results A total of 40 CAPD week treatment, levels of serium phosphate （t=5.095, P=0.000） patients were included, 20 cases in each group. After 12- and iPTH （t=1.225, P=0.000） in the lanthanum carbonate group were significantly lower than those before treatment. The levels of serum calcium （t= 1.127, P=0.001） and phosphate （t=2.035, P=0.000） in the lanthanum carbonate group were significantly lower than those in the calcium carbonate group （P〈0.05）. Conclusion Lanthanum carbonate serves as a useful approach to improve hypercalcemia and the hyperphosphatemia in CAPD patients receiving calcitriol pulse therapy due to SHPT.