碳酸镧联合骨化三醇冲击治疗血透患者继发甲状旁腺功能亢进的疗效观察

目的探讨碳酸镧联合骨化三醇冲击治疗血透患者继发性甲状腺旁腺功能亢进的疗效。方法维持性血透继发甲状腺旁腺功能亢进患者52例，随机分为观察组与对照组，观察组予骨化三醇软胶囊4μg／次，2次／周，碳酸镧500mg，3次／d，随餐嚼服。对照组予骨化三醇软胶囊4μg／次，2次／周加安慰剂口服。骨化三醇剂量根据血甲状旁腺激素（PTH）调整，共观察6个月。结果治疗后ab-PTH下降，观察组与对照组各个时段（456．8±142．6）ng／Lvs（554．5±128_3）ng／L，（356．8±89．6）ng／Lvs（486．5±96．5）ng／L，（215．6±78．3）ng／Lvs（376．8±100．1）ng／L，比较差异有统计学意义（P〈0．05）。观察组血磷与对照组比较下降明显，6个月时（1.51±0．14）mmol／Lvs（1．80±0．26）mmol／L，（P〈0．05）。观察组血钙水平比较差异无统计学意义（P〉0．05）。结论碳酸镧联合骨化三醇较单用骨化三醇冲击治疗维持性血透患者继发性甲状腺旁腺功能亢进疗效好。

Objective To investigate the effectiveness of impact therapy of Lanthanum carbonate combined with Calcitriol in hemodialysis patients with secondary hyperparathyroidism. Methods A total of 52 cases of maintenance hemodialysis patients with secondary hyperparathyroidism were randomly divided into observation and control group. The observation group was administered with Calcitriol soft capsule 4 μg, 2 times per week, along with Lanthanum carbonate 500mg, 3 times per day. The control group was given Calcitriol soft capsule 4 μg, 2 times per week, along with a dose of placebo. The dose of Calcitriol was adjusted according to PTH in an observation period of 6 months. Results The declining levels of PTH of observation and control groups in different time intervals were as follows： observation group vs control group, （ 456.8 ± 142.6 ） ng/L vs （554.5±128.3） ng/L, （356.8±89.6） ng/Lvs （486.5±96.5） ng/L, （215.6±78.3） ng/Lvs （376.8±100.1） ng/L, （P〈0.05） . Serum phosphate levels in observation group decreased markedly than in control group till 6 months, （ 1.51 ± 0.14 ） mmol/L vs （ 1.80 ± 0.26 ） mmol/L, （ P〈0.05 ） . Serum calcium levels had no significant difference in two groups （ P〉0.05 ） . Conclusions Compact therapy of Lanthanum carbonate combined with Calcitriol has better effectiveness than Calcitriol in hemodialysis patients with secondary hyperparathyroidism.