大剂量骨化三醇冲击疗法对终末期肾病患者并发继发性甲状旁腺功能亢进的疗效

Clinical effect of high dose of calcitriol on end-stage renal disease patients complicated with secondary hyperparathyroidism

目的 探讨大剂量骨化三醇冲击疗法对终末期肾病（end-stage renal disease,ESRD）患者并发继发性甲状旁腺功能亢进（secondary hyperparathyroidism,SHPT）的临床疗效。方法 回顾性分析ESRD并发SHPT患者的临床资料,根据其治疗方式分为对照组和观察组,对照组给予常规剂量骨化三醇治疗,观察组给予大剂量骨化三醇治疗。观察2组患者治疗前后钙磷水平、甲状旁腺激素（parathyroid hormone,PTH）水平和生活质量的差异。结果 2组患者治疗前血磷、血钙和钙磷乘积无明显差异,治疗后,2组患者的上述指标均较治疗前降低,且观察组降低更明显（P〈0.05）;治疗前,2组患者的PTH水平无差异,治疗后,观察组的PTH水平较对照组低,差异有统计学意义（P〈0.05）;2组患者治疗前生活质量得分无明显差异,治疗后,2组患者生活质量均较治疗前增高,且观察组增高更明显（P〈0.05）。结论大剂量骨化三醇冲击疗法对ESRD并发SHPT患者有较好的治疗效果,可明显改善患者的钙磷代谢和PTH水平,提高患者生活质量。

Objective To investigate the clinical effect of high dose of calcitriol on end-stage renal disease （ESRD） in patients with secondary hyperparathyroidism （SHPT）. Methods The clinical data of patients with ESRDcomplicated with SHPT were retrospectively analyzed. According to the treatment method were divided into control group and observation group, the control group were given conventional dose of calcitriol treatment, the observation group were treated with high dose of calcitriol. The differences of calcium and phosphorus levels, parath^oid hormone （PTH） level and quality of life were observed between the two groups before and after treatment. Results The serum phosphorus, calcium and calcium- phosphorus product in two groups of patients before treatment had no significant difference. After treatment, the above indicators decreased in two groups of patients compared with those before treatment, and the observation group was significantly lower （P〈0.05）. Before treatment, there was no difference in the levels of PTH between the two groups. After treatment, the level of PTH in the observation group was lower than that in the control group, and the difference was statistically significant （P〈0.05）. There was no significant difference in quality of life between the two groups before treatment. After treatment,the quality of life in the two groups were higher than before treatment,and the observation group was significantly higher （P〈0.05）. Conclusion High dose of calcitriol has good therapeutic effect for ESRD patients with SHPT and can significantly improve the patient＇s calcium and phosphorus and PTH levels, improve the quality of life of patients.