静脉注射活性维生素D治疗继发性甲状旁腺功能亢进的疗效

Effect of Intravenous Administration of Active Vitamin D in Treatment of Secondary Hyperparathyroidism

目的观察静脉注射活性维生素D治疗继发性甲状旁腺功能亢进的疗效。方法选取本院收治的60例维持性血液透析伴继发性甲状旁腺功能亢进(SHPT)患者作为研究对象,随机分为治疗组和对照组。治疗组与对照组分别给予骨化三醇注射液和骨化三醇软胶囊,iPTH 300～600 pg/dL者给予1μgtiw,iPTH(600～1 000 pg/dL)给予2μgtiw,iPTH> 1 000 pg/dL)者给予3μg tiw。入组患者,停用钙剂及活性维生素D制剂2周(药物洗脱期)后复查血Ca、P、iPTH,并开始治疗,治疗4周后、8周后比较血Ca、P、iPTH水平。结果治疗组与对照组治疗4周后、8周后iPTH明显下降,组间比较差异有统计学意义(P <0.05);血钙皆有明显升高,组间比较差异有统计学意义(P <0.05)。对照组有3例血钙大于2.75 mmol/L而停药。结论静脉注射活性维生素D治疗维持性血液透析伴继发性甲状旁腺功能亢进安全有效。

Objective To observe the effect of intravenous injection of active vitamin D in the treatment of secondary hyperparathyroidism. Methods A total of 60 patients with maintenance hemodialysis combined with secondary hyperparathyroidism(SHPT)in our hospital were randomly divided into treatment group and control group. In the treatment group and the control group,ossified triol injection and ossified triol soft capsule were given respectively;iPTH(300~600 pg/dL)was given 1μg tiw;iPTH(600~1 000 pg/dL)was given 2μg tiw;iPTH(>1 000 pg/dL)was given 3μg tiw. After 2 weeks of discontinuation of calcium and active vitamin D preparations(drug washout period),the blood Ca,P and iPTH were reexamined and the treatment was started. After 4 weeks and 8 weeks of treatment,the blood Ca,P and iPTH levels were compared. Results IPTH decreased significantly in the treatment group and the control group 4 weeks after treatment and 8 weeks after treatment(P<0.05).was compared between the groups and within the groups(P<0.05). Conclusion Intravenous injection of active vitamin D is safe and effective in the treatment of maintenance hemodialysis with secondary hyperparathyroidism.