血液透析者继发性甲状旁腺功能亢进的药物治疗

Drug Therapy for Secondary Hyperparathyroidism in Hemodialysis Patients

目的探讨西那卡塞联合骨化三醇对血液透析患者继发性甲状旁腺功能亢进的价值。方法收集我院血液透析继发性甲状旁腺功能亢进的患者作为研究对象,将其分为研究组和对照组。两组基础治疗方法为口服骨化三醇联合血液透析,研究组加用西那卡塞治疗,对比两组患者治疗前后甲状旁腺大小、血钙、血磷、钙磷乘积及肾功能。结果两组患者治疗前甲状旁腺大小比较,差异无统计学意义(P> 0.05);两组患者治疗后甲状旁腺大小比较,差异具有统计学意义(P <0.05);治疗前,两组患者血钙、血磷及钙磷乘积比较,差异无统计学意义(P> 0.05);两组患者治疗后血钙、血磷及钙磷乘积比较,差异具有统计学意义(P <0.05);两组患者治疗前肾功能比较,差异无统计学意义(P> 0.05);两组患者治疗后肾功能比较,差异具有统计学意义(P <0.05)。结论西那卡塞联合骨化三醇治疗血液透析患者继发性甲状旁腺功能亢进的临床疗效较好,维持体内钙磷平衡,保护患者残肾功能。

Objective To investigate the value of sinacases combined withcalcitriol in the treatment of secondary hyperparathyroidism in hemodialysis patients. Methods The patients with secondary hyperparathyroidism after hemodialysis in our hospital were collected as the research objects and divided into study group and control group. The basic treatment of the two groups was oral calcitriol combined with hemodialysis. The study group was treated with sinakase. The size of parathyroid gland, serum calcium, phosphorus, calcium-phosphorus product and renal function were compared between the two groups before and after treatment. Results There was no significant difference in the size of parathyroid glands between the two groups before treatment(P>0.05). After treatment, the size of parathyroid glands in the two groups was significantly different(P<0.05). Before treatment, there was no significant difference in blood calcium, blood phosphorus and calcium-phosphorus product between the two groups(P>0.05). There were significant differences in blood calcium, phosphorus and product of calcium and phosphorus between the two groups after treatment(P<0.05). There was no significant difference in renal function between the two groups before treatment(P>0.05). The difference of renal function between the two groups after treatment was statistically significant(P<0.05). Conclusion Sinakase combined with calcitriol is effective in treating secondary hyperparathyroidism in hemodialysis patients, maintaining calcium and phosphorus balance in vivo and protecting residual renal function.