碳酸司维拉姆治疗血液透析合并高磷血症的效果观察

Effects of sevelamer carbonate on hemodialysis with hyperphosphatemia

目的:观察碳酸司维拉姆治疗血液透析(HD)合并高磷血症的治疗效果。方法:选择某院收治的64例HD合并高磷血症患者,按随机数字表法分为2组,每组32例。对照组给予常规药物治疗,观察组给予碳酸司维拉姆治疗。比较治疗前、治疗3月后肾功能指标[尿素氮(BUN)、血肌酐(SCr)、尿肌酐(Cr)]、矿物质骨代谢指标[血钙、血磷、成纤维生长因子(FGF-23)、血红素过氧化氢酶1(HO-1)]及炎症因子[血清白介素(IL)-6、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)]水平。结果:治疗3月后,2组患者肾功能指标、矿物质骨代谢指标、各炎症因子水平均较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05);观察组血钙水平较治疗前无明显差异(P>0.05),对照组血钙水平较治疗前升高(P<0.05)。结论:碳酸司维拉姆能提高HD合并高磷血症患者的肾功能及钙磷代谢水平,减轻机体炎症反应。

Objective:To observe the therapeutic effects of sevelamer carbonate in treatment of hemodialysis(HD)with hyperphosphatemia.Methods:64 patients with HD and hyperphosphatemia admitted to a hospital were selected for the study.They were randomly divided into two groups,with 32 cases in each.The control group was given conventional drug treatment,and the observation group was treated with sevelamer carbonate.The renal function indicators[blood urea nitrogen(BUN),serum creatinine(SCr),urine creatinine(Cr)],mineral bone metabolism indexes[blood calcium,blood phosphorus,fibroblast growth factor(FGF-23),heme oxygenase-1(HO-1)]and inflammatory factors[serum interleukin(IL)-6,high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)]were compared between the two groups before the treatment and 3 months after the treatment.Results:3 months after the treatment,levels of renal function indicators,some mineral bone metabolism indexes and inflammatory factors in the two groups were lower than those before the treatment,and the levels in the observation group were lower than those in the control group(P<0.05).There was no significant difference in blood calcium level in the observation group compared with that before the treatment(P>0.05),while the level in the control group was higher than that before the treatment(P<0.05).Conclusion:Sevelamer carbonate can improve the renal function,calcium and phosphorus metabolism and reduce the body's inflammatory response in patients with HD and hyperphosphatemia.