西那卡塞与维生素D治疗SHPT的临床研究

Clinical Study of Cinacalcet and Vitamin D in the Treatment of SHPT

目的探讨分析尿毒症继发性甲状旁腺功能亢进患者采用西那卡塞联合小剂量活性维生素D治疗的效果分析,为临床应用提供参考依据。方法选取2018年1月—2020年1月在本院血液透析中心维持性血液透析的SHPT患者90例,根据治疗药物不同随机分为西那卡塞联合维生素D治疗组(观察组)和西那卡塞治疗组(对照组1)、活性维生素D治疗组(对照组2),每组30例患者。分别检测此三组患者治疗前及治疗后2、4、8、12周甲状旁腺激素水平、血清钙以及血磷,药量调整的方法可依照检测结果为标准。结果治疗前、治疗后第2、4周三组患者血iPTH、血钙、血磷相比差异均无统计学意义(P>0.05),且第8周时,观察组与对照组1血iPTH、血钙、血磷相比差异仍无统计学意义(P>0.05),至治疗第12周时,观察组患者血iPTH、血磷明显下降,血钙控制良好。结论西那卡塞联合小剂量活性维生素D治疗维持性血液透析SHPT患者安全、有效。

Objective To explore the analysis of the effect of cinacase combined with low-dose active vitamin D treatment in patients with secondary hyperparathyroidism in uremia,and to provide a reference for clinical application.Methods Ninety patients with SHPT who underwent maintenance hemodialysis in our hospital hemodialysis center from January 2018 to January 2020 were randomly divided into cinacalcet combined with vitamin D treatment group(observation group)and cina There were 30 patients in the Kasai treatment group(control group 1)and the active vitamin D treatment group(control group 2).The levels of parathyroid hormone,serum calcium,and blood phosphorus were measured before treatment and at 2,4,8,and 12 weeks after treatment in these three groups of patients.The method of dose adjustment can be based on the test results.Results During the treatment,the patients had good tolerance and compliance to the drug.The serum levels of parathyroid hormone in the observation group were significantly lower than those before treatment,and the blood calcium and phosphorus were well controlled.Conclusions Cinacalcet combined with low-dose active vitamin D is safe and effective for patients with maintenance hemodialysis SHPT.