碳酸司维拉姆治疗慢性肾功能不全合并高磷血症的疗效

Efficacy of Sevelamer Carbonate in the Treatment of Chronic Renal Insufficiency with Hyperphosphatemia

目的分析碳酸司维拉姆应用于慢性肾功能不全合并高磷血症对患者血磷、血钙及炎症反应的影响。方法选取2017年6月~2019年6月在我院诊治的64例慢性肾功能不全合并高磷血症患者为研究对象,采用随机数字表法分为对照组和观察组,各32例。对照组采用碳酸钙治疗,观察组在对照组基础上给予碳酸司维拉姆治疗,比较两组治疗前后血磷、血钙、全段甲状旁腺素(iPTH)、炎性指标(IL-6、CRP)及不良反应发生情况。结果治疗后两组血磷低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后对照组血钙高于治疗前,且高于观察组(P<0.05);治疗后对照组iPTH低于治疗前,且低于观察组(P<0.05);观察组治疗后血钙、iPTH与治疗前比较,差异无统计学意义(P>0.05);治疗后两组IL-6、CRP均低于治疗前,且观察组低于对照组(P<0.05);观察组临床不良反应发生率(15.62%)高于对照组(6.25%)(P<0.05)。结论碳酸司维拉姆治疗慢性肾功能不全合并高磷血症,可有效降低患者血磷水平、全段用甲状旁腺素以及炎症因子指标,在临床慢性肾功能不全合并高磷血症治疗中具有重要意义。

Objective To analyze the effects of sevelamer carbonate on chronic renal insufficiency combined with hyperphosphatemia on blood phosphorus,calcium and inflammation.Methods 64 patients with chronic renal insufficiency and hyperphosphatemia diagnosed and treated in our hospital from June 2017 to June 2019 were selected as the research subjects.They were divided into control group and observation group by random number table method,with 32 cases in each group.The control group was treated with calcium carbonate,and the observation group was treated with sevelamer carbonate on the basis of the control group.The levels of blood phosphorus,calcium,whole parathyroid hormone(iPTH),inflammatory indicators(IL-6,CRP)and adverse reactions were compared between the two groups before and after treatment.Results After treatment,the blood phosphorus levels of the two groups were lower than before the treatment,and the observation group was lower than the control group,the difference was statistically significant(P<0.05);The serum calcium in the control group after treatment was higher than that before treatment and higher than that in the observation group(P<0.05);the iPTH in the control group after treatment was lower than that before the treatment and lower than the observation group(P<0.05);there was no significant difference in blood calcium and iPTH between the observation group and before treatment(P>0.05);IL-6 and CRP in the two groups after treatment were lower than before treatment,and the observation group was lower than the control group,(P<0.05);the incidence of clinical adverse reactions in the observation group(15.62%)was higher than that in the control group(6.25%)(P<0.05).Conclusion Sevelamer carbonate in the treatment of chronic renal insufficiency combined with hyperphosphatemia can effectively reduce blood phosphorus levels,lower the whole parathyroid hormone,and reduce the index of inflammatory factors is of great significance.