碳酸镧对透析患者血管钙化的影响及其可能机制

Effect and Possible Mechanism of Lanthanum Carbonate on Vascular Calcification in Dialysis Patients

目的:探讨碳酸镧对透析患者血管钙化的影响及可能作用机制。方法:选择本院2013年1月-2014年8月收治的30例规律透析患者(透析至少3个月)为研究对象,给予所有患者为期12周的碳酸镧治疗,比较治疗前后该组患者i PTH(血清全段甲状旁腺素)、FGF23(成纤维细胞生长因子23)、25(OH)D(血清25羟维生素D)等指标水平。另外停用碳酸镧后继续服用1个月的碳酸钙,比较两组上述指标水平。结果:碳酸镧治疗前后血磷水平比较,差异有统计学意义(P<0.05)。碳酸镧治疗后、碳酸钙用药1个月后患者血磷、FGF23比较,差异有统计学意义(P<0.05)。另外,碳酸镧治疗期间不良反应发生率20.00%。结论:碳酸镧在治疗透析患者高磷血症、防止血管钙化中有重要作用,且碳酸镧可能是通过降低FGF23及血磷水平达到预防血管钙化的目的。

Objective： To investigate the effect and possible mechanism of lanthanum carbonate on vascular calcification in dialysis patients. Method： 30 regular hemodialysis patients （ dialysis for at least 3 months ） admitted to our hospital from January 2013 to August 2014 as the research objects, and were given the lanthanum carbonate treatment for 12 weeks, to compare iPTH （ serum intact parathyroid hormone ）, FGF23 （ fibroblast growth factor 23 ）, 25 （ OH ） D （ serum 25 hydroxy vitamin D ） and other indicators level before and after treatment of patients. In addition, to take calcium carbonate for 1 month after disable lanthanum carbonate, and compare the index level of the two groups. Result： The serum phosphate before and after lanthanum carbonate treatment between the two groups, the difference was statistically significant （ P〈O.05 ） . In addition, lanthanum carbonate, calcium carbonate treatment for 1 month after the patients blood phosphorus, the differences were significant （ P〈0.05 ） . In addition, the incidence of adverse reactions was 20.00% during the lanthanum carbonate treatment. Conclusion： Lanthanum carbonate has an important role in the treatment of dialysis patients with hyperphosphatemia, prevent to vascular calcification, and lanthanum carbonate may be through the reduction of FGF23 and blood phosphorus level to achieve the purpose of prevention of vascular calcification.