碳酸镧治疗维持性血液透析患者高磷血症的临床疗效观察

CLINICAL STUDY OF LANTHANUM CARBONATE TREATMENT IN MAINTENANCE HEMODIALYSIS PATIENTS WITH HYPERPHOSPHATEMIA

目的通过口服碳酸镧治疗维持性透析患者高磷血症,评价碳酸镧治疗维持性透析患者并发高磷血症的有效性。方法选择2013年6月—2014月8月在该院血液净化中心规律透析12个月以上顽固性高磷血症患者41例。分为治疗组和观察组。二组患者在基础疾病、临床特征及性别年龄方面差异均无统计学意义(P>0.05),治疗组口服醋酸钙片1g/d;观察组应用碳酸镧咀嚼片0.75g/d,治疗2个月。在二组在治疗前、治疗2个月末进行采血检查血磷、血钙、全段甲状旁腺素指标变化。结果与治疗前比较,观察组患者服用碳酸镧治疗后2个月血磷均下降差异有统计学意义(P<0.01)。治疗组患者血磷治疗前、后两者比较差异无统计学意义;二组比较,观察组服用碳酸镧后血磷下降更明显(P<0.01)。治疗组对血钙下降不明显(P>0.05);与治疗前比较,观察组在应用碳酸镧治疗后血iPTH明显下降,差异有统计学意义((P<0.05))。结论碳酸镧治疗维持性透析患者高磷血症较传统含钙降磷药物具有明显的疗效,且安全性好。

Objective To evaluate the effectiveness of oral Lanthanum carbonate in treatment of hyperphosphatemia in hemodialysis patients.Methods From June 2013 to August 2014,41 cases were selected in author＇s hospital dialysis purification law12 months or more refractory hyperphosphatemia patients,and they were divided into treatment and observation groups.Two groups of patients were not statistically different（P 〉0.05）,the treatment group was treated with Calcium acetate 1g/d on the basis of the disease,observation group received Lanthanum carbonate chewable tablets 0.75g/d.The blood Phosphorus,Calcium,serum intact Parathyroid hormone（iPTH）before treatment and the end of two months.Results Compared with before treatment,patients taken Lanthanum carbonate in the observation group two months after treatment decreased serum Phosphate,（P 〈0.01）,but it was no significant decreased in the patients with treatment group.Two months after treatment,blood Phosphorus of the observation group decreased more significantly than the treatment group（P 〉0.01）.Compared with before treatment,no significant decline was observed in the observation group of Calcium（P 〈0.05）,but serum iPTH was significantly decreased after applying Lanthanum carbonate treatment（P 〈0.05）.Conclusion Lanthanum carbonate treatment in maintenance dialysis patients hyperphosphatemia have a significant effect and security.