碳酸镧治疗维持性血液透析疗效及对患者冠状动脉钙化的影响

Curative Effects of Lanthanum Carbonate in Maintenance Hemodialysis and Its Influence on Coronary Artery Calcification

目的:探讨碳酸镧治疗维持性血液透析疗效及对患者冠状动脉钙化的影响。方法:将我院2018年8月至2019年7月收治的105例维持性血液透析伴高磷血症患者作为研究对象,按照简单随机分组法分为对照组(n=52)和观察组(n=53),前者给予碳酸钙治疗,后者给予碳酸镧治疗,对比两组治疗前后血钙(Ca)、血磷(P)、全段甲状旁腺激素(iPTH)、骨碱性磷酸酶(BALP)、成纤维细胞生长因子(FGF-23)水平、左心室质量指数(LVMI)和冠状动脉钙化积分(CACS),以及不良反应。结果:观察组治疗总有效率优于对照组(P<0.05);观察组治疗前后血清Ca、P、iPTH水平差值均大于对照组(P<0.05),血清FGF-23、ALP水平差值均大于对照组(P<0.05),LVMI和CACS差值均小于对照组(P<0.05);两组不良反应发生率比较差异不显著(P>0.05)。结论:碳酸镧治疗维持性血液透析伴高磷血症疗效较好,能够改善患者冠状动脉钙化情况。

Objective:To explore the effects of lanthanum carbonate(LC)in maintenance hemodialysis(MHD)and the influence on coronary artery calcification(CAC).Methods:A total of 105 hyperphosphatemia patients who underwent MHD and were admitted to the hospital from August 2018 to July 2019 were enrolled as study objects.They were divided into control group(n=52)and observation group(n=53)by simple random grouping method.The former was treated with calcium carbonate,while the latter was treated with LC.The levels of serum calcium(Ca),serum phosphorus(P),intact parathyroid hormone(iPTH),bone alkaline phosphatase(BALP)and fibroblast growth factor(FGF-23),left ventricular mass index(LVMI),coronary artery calcification scores(CACS)before and after treatment and adverse reactions were compared between the two groups.Results:The effective rate of treatment in observation group was better than that in control group(P<0.05).Differences of serum Ca,P,iPTH,FGF-23 and ALP levels in observation group before and after treatment were larger than those in control group(P<0.05),while the differences of LVMI and CACS were smaller than those in control group(P<0.05).There was no significant difference in incidence of adverse reactions between the two groups(P>0.05).Conclusion:The curative effect of LC is good on MHD combined with hyperphosphatemia,which can improve CAC in patients.