骨化三醇注射液治疗血液透析患者难治继发性甲状旁腺功能亢进的临床观察

Clinical observation about Calcitriol injection curing refractory secondary hyperparathyroidism in hemodialysis patients

目的观察骨化三醇注射液治疗骨化三醇胶囊口服无效的继发性甲状旁腺功能亢进(secondary hyperparathyroidism,SHPT)的疗效。方法选取石河子市人民医院2014年1月至2015年11月血液透析(hemodialysis,HD)的继发性甲状旁腺功能亢进的患者,选择其中对骨化三醇胶囊口服冲击无效的28例,给予骨化三醇注射液,比较治疗前及治疗后2、4、8周的全段甲状旁腺激素、血钙、血磷的变化及临床症状的缓解程度。结果 128例患者治疗前血清全段甲状旁腺激素(1186.7±305)pg/ml,治疗后8周血清全段甲状旁腺激素(506.2±146)pg/ml,总达标率87.1%。2血磷及血钙变化不大。3临床症状骨痛、皮肤瘙痒、四肢无力、关节痛有不同程度缓解。结论骨化三醇注射液在骨化三醇胶囊冲击无效的情况下,对继发性甲状旁腺功能亢进的患者依然有效。

Objective To observe the curative effect of calcitriol injection on secondary hyperparathyroidism when oral calcitriol capsule was invalid.Methods 28 cases of emodialysis patients with secondary hyperparathyroidism from January 2014 to November2015 who were proven to be invalid when taken orally calcitriol capsule were selected.All cases were given calcitriol injection.i PTH,blood calcium and blood phosphorus and relief of clinical symptoms before treatment and 2,4,8 weeks after treatment were compared.Results（1）,i PTH in 28 patients before treatment were average 1186.7±305 pg/ml,while i PTH changed into 506.2±146 pg/ml at eight weeks after treatment,and the total control rate was 87.1%.（2） There were no obvious changes about values of blood phosphorus and calcium.（3） The clinical symptoms of bone pain,itchy skin,limb weakness,joint pain were relieved to different extent.Conclusion Injection of calcitriol is still valid to patients with secondary hyperparathyroidism when it is invalid if they are taken calcitriol capsule.