骨化三醇冲击治疗尿毒症继发性甲状旁腺功能亢进

Ossification in three alcohol shock treatment in uremic patients with secondary hyperparathyroidism

目的采用骨化三醇口服冲击治疗继发性甲旁亢患者,观察其疗效和安全性。方法将38例符合标准的患者随机分为对照组(骨化三醇0.25ug qn)和治疗组(骨化三醇2.0ug biw)各19例,两组患者均禁服钙制剂,予钙浓度1.5 mmol/L的碳酸氢盐透析液进行血液透析及相关治疗,对照组骨化三醇常规量口服,治疗组骨化三醇冲击量口服,连续治疗12周,对比两组患者血清钙、磷和甲状旁腺激素指标和不良反应的差异性。结果对照组治疗前后血钙、磷、钙磷乘积无明显变化(P>0.05),甲状旁腺激素在治疗后由(736.63±152.38)降至(714.36±172.55),呈轻度下降,但P>0.05,无统计学意义。治疗组治疗后与自身治疗前比较血钙、血磷、钙磷乘积无显著变化(P>0.05),而甲状旁腺激素由(713.37±154.33)pg/m L降至(321.45±98.72)pg/m L,呈明显下降(P<0.01)。结论采用骨化三醇冲击治疗,能有效控制尿毒症继发性甲旁亢,并且不良反应少,安全可行,值得临床推广。

Objective To impact calcitriol oral treatment of patients with secondary near a port, to observe its efficacy and safety.Methods 38 patients with standard were randomly divided into control group（0.25 ug qn calcitriol） and treatment group（calcitriol2.0 ug biw） 19 cases, two groups of patients were forbidden take calcium preparations, to calcium concentration tendency for 1.5/L bicarbonate dialysate in hemodialysis and related treatment, control amount of calcitriol conventional oral, treatment group of oral calcitriol impact quantity, continuous 12 weeks of treatment, compared two groups of patients with serum calcium, phosphorus and parathyroid hormone indexes and the difference of adverse reactions. Results In the control group before and after treatment the blood calcium, phosphorus and the calcium-phosphorus product no significant change（P〉 0.05）, parathyroid hormone after treatment by（736.63±152.38） to（714.36±172.55）, a slight decline, but P〉0.05, no statistical significance. Treatment group after treatment compared with before their treatment of blood calcium and blood phosphorus and the calcium-phosphorus product had no significant change（P〉0.05）, and parathyroid hormone by（713.37±154.33） pg/m L fell to（321.45±98.72） pg/m L, was significantly decreased（P〈0.01）. Conclusion Calcitriol shock treatment, can effectively control the uremia secondary near a port, and less adverse reaction, safe and feasible, is worth clinical promotion.