降钙素对高转运性肾性骨病及心血管异位钙化的治疗作用

Effects of calcitonin on high transport renal osteodystrophy and cardiovascular ectopic calcification

目的探讨降钙素对于高转运性肾性骨病及心血管异位钙化的治疗作用。方法将40例行维持性血液透析治疗伴有肾性骨病症状的患者随机分为实验组及对照组。对照组采用活性维生素D3口服治疗,实验组在活性维生素D3治疗基础上联合降钙素肌注,疗程3个月。治疗结束后应用双能X射线骨密度仪测量2组股骨颈骨密度值;治疗前后治疗前后应用全自动生化分析仪检测血钙、血磷、血甲状旁腺激素水平,使用酶联免疫吸附法检测Ⅰ型胶原N-端前肽、Ⅰ型胶原交联C-末端肽、胎球蛋白A值。结果治疗后,实验组的钙化评分、Ⅰ型胶原N-端前肽、Ⅰ型胶原交联C-末端肽较对照组下降更为明显(P<0.05),股骨头骨密度显著提高(P<0.05);2组治疗后血钙、血磷、胎球蛋白A值比较差异均无统计学意义。结论降钙素联合活性维生素D治疗可明显改善肾性骨病患者骨质代谢,对转移性钙化具有一定的抑制作用,但效果尚未明确。

Objective It is to investigate the effects of calcitonin on high transport renal osteodystrophy and cardiovascular ectopic calcification. Methods 40 patients with symptoms of renal osteodystrophy treated with maintenance hemodialysis were randomly divided into experimental group and control group. The control group was treated with active vitamin D3 by oral ad- ministration, the experimental group was treated with ealcitonin by intramuscular administration on the basis of treatment with active vitamin D3. Both the treatment courses were 3 months. After treatment dual energy X - ray absorptiometry was used to measure femoral neck BMD values in both groups, automaticbiochemical analyzer was used to determine the levels of blood calcium, phosphorus and parathormone, enzyme linked immunosorbent assay was used to detect PIPN, CTX, AHSG before and after after treatment. Results After treatment, calcification scores, the levels of PIPN and CTX were more lower while the bone density of femoral head was more higher in experimental group than that of the control group（ P 〈 0. 05 ） , there was no significant difference in serum calcium, phosphorus, AHSG between both groups after treatment（P 〉 0. 05 ）. Conclusion Calcitonin combined with active vitamin D can significantly improve bone metabolism in the patients with renal osteodystrophy; and has some inhibiting effect on metastatic calcification, but the effect is not yet clear.