活性维生素D临床应用

Clinical application of active vitamin D

活性维生素D在临床上应用广泛。对于肝、肾功能逐渐衰退,伴有肌少症和/或神经功能损害的老年骨质疏松症(osteoporosis,OP)患者,妊娠/哺乳相关的OP及骨密度(bone mineral density,BMD)下降患者,均可适当补充。活性维生素D联合钙剂是甲状旁腺功能减退症和骨软化症的首选治疗方案,同时也是慢性肾脏病-矿物质和骨异常患者预防和治疗继发性甲状旁腺功能亢进症的主要措施之一。活性维生素D治疗窗相对狭窄,用药期间需要定期监测安全性指标,如血钙磷、尿钙磷及全段甲状旁腺素等。

Active vitamin D is widely used in clinical practice. For senile osteoporosis patients with declined liver and kidney function,with sarcopenia and/or nerve damage,pregnancy/lactation related osteoporosis or bone loss,active vitamin D can be complemented appropriately. Active vitamin D combined with calcium is the preferred treatment protocol for patients with hypoparathyroidism and osteomalacia,as well as one of the main interventions for patients with chronic kidney disease-mineral and bone disorder for the prevention and treatment of secondary hyperparathyroidism. The treatment window of active vitamin D is relatively narrow,and the safety index such as serum calcium/phosphorus,urinary calcium/phosphorus,intact parathyroid hormone should be regularly monitored during treatment.