碳酸镧咀嚼片联合醋酸钙片治疗维持性血液透析患者高磷血症的临床研究

Clinical trial of lanthanum carbonate chewable tablets combination with calcium acetate tablets in the maintenace treatment of hemodialysis patients with hyperphosphatemia

目的观察碳酸镧联合醋酸钙治疗维持性血液透析患者高磷血症的临床疗效。方法将70例维持性血液透析高磷血症患者随机分为试验组35例和对照组35例。对照组给予醋酸钙片,起始剂量为醋酸钙片667 mg,每日3次,口服;试验组在对照组的基础上给予碳酸镧咀嚼片250 mg,每日3次,口服。2组均治疗12周。评价2组患者的临床疗效及血磷、血钙、甲状旁腺素水平(iPTH),并观察2组的药物不良反应发生情况。结果治疗后,试验组降磷总有效率91.43%(32/35例),对照组为71.43%(25/35例),差异有统计学意义(P<0.05)。治疗后,试验组血磷、血钙、iPTH分别为(1.73±0.16)mmol·L^(-1),(2.25±0.15)mmol·L^(-1),(189.60±68.49)pg·mL^(-1),对照组分别为(1.88±0.29)mmol·L^(-1),(2.45±0.19)mmol·L^(-1),(217.83±64.00)pg·mL^(-1),差异均有统计学意义(均P<0.05)。试验组出现恶心呕吐2例,药物不良反应率为5.71%(2/35例);对照组出现腹痛1例,药物不良反应率为2.86%(1/35例);2组药物不良反应发生率差异无统计学意义(P>0.05)。结论碳酸镧联合醋酸钙可有效治疗维持性血液透析患者高磷血症,且安全性较好。

Objective To evaluate the clinical efficacy of lanthanum car- bonate combined with calcium acetate in the treatment of hemodialysis patients with hyperphosphatemia. Methods A total of 70 cases with he- modialysis were randomly divided into treatment group（ n = 35） and con- trol group（ n = 35 ）. Patients in control group were orally given calcium acetate 667 mg, tid. Patients in treatment group were orally given lantha- num carbonate 250 mg, tid on the basis of control group. All patients were treated for 12 weeks. The clinical effect and levels of phosphorus, cal-cium and intact parathyroid hormone （iPTH） in two groups were ob- served. Also, the adverse drug reactions in two groups were observed. Results After treatment, the total efficacy rates in treatment group and control group were 91.43% （32/35）, 71.43% （ 25/35 ）, with significant difference （ P 〈 0. 05 ）. After treatment, the levels of phosphorus, calcium and iPTH in treatment group were （1.73 ± 0. 16）mmol·L^-1, （2.25 ±0. 15）mmol ·L^-1, （189.60 ±68.49）pg ·mL^-1, had signifi- cant difference with those in control group, which were （ 1.88 ± 0. 29 ） mmol ·L^-1, （2.45 ±0. 19）mmol ·L^-1, （217.83 ±64.00）pg ·mL^-1（P 〈 0. 05 ）. There were 2 cases of nausea and vomiting in treatment group, with the incidence of 5.71% （2/35 eases）. There was 1 ease of abdominal pain in control group, with the incidence of 2.86% （ 1/35 eases, P 〉 0. 05 ）. Conclusion The clinical effect of lanthanum carbonate combined with calcium acetate is great in the treatment of hemodialysis patients with hyperphosphatemia.