不同起始剂量的帕立骨化醇治疗血液透析伴继发性甲状旁腺亢进患者的有效性

Effectiveness of different starting doses of paricalcitol in the treatment of hemodialysis patients with secondary hyperparathyroidism

目的探讨不同起始剂量的帕立骨化醇(PCT)治疗血液透析伴继发性甲状旁腺功能亢进(SHPT)患者12周的有效性。方法选取我院2017年6月至2020年6月收入的30例维持性血液透析伴SHPT患者,采用随机排列表法分为A组与B组,每组各15例。A组患者采用PCT起始剂量0.06μg/kg,3次/周,透析后给药;B组采用iPTH(pg/mL)/80μg公式计算PCT的起始剂量,3次/周,透析后给药。比较两组患者治疗12周后iPTH值、iPTH达标率、不良反应发生率及血钙、磷水平。结果治疗12周后,A组iPTH数值低于B组,iPTH达标率高于B组,差异均有统计学意义(P<0.05);A组血钙、血磷浓度显著低于B组,差异有统计学意义(P<0.05);A组不良反应发生率显著低于B组,差异有统计学意义(P<0.05)。结论采用起始剂量0.06μg/kg的PCT,较之全段iPTH(pg/mL)/80μg起始剂量给药方案治疗血液透析伴SHPT患者,可显著改善SHPT,血钙、血磷波动较小,且不良反应发生率较低,值得应用与推广。

Objective To explore the efficacy of different starting doses of pericalcitol(PCT)in the treatment of hemodial-ysis patients with secondary hyperparathyroidism(SHPT)for 12 weeks.Methods The research subjects were 30 patients with maintenance hemodialysis combined with SHPT who were admitted to our hospital from June,2017 to June,2020.They were randomLy divided into group A and group B,with 15 patients in each group.The starting dose of PCT in group A was 0.06μg/kg,3 times a week,and was given after dialysis.The starting dose of PCT in group B was calcu-lated by the formula of iPTH(pg/mL)/80μg,3 times a week,and was given after dialysis.The iPTH values,iPTH con-trol rates,incidences of adverse reactions and serum calcium and phosphorus levels were compared between the 2 groups after 12 weeks of treatment.Results After 12 weeks of treatment,the iPTH value of group A was lower than that of group B,and the iPTH control rate was higher than that of group B,with statistical significance(P<0.05).The serum calcium and phosphorus concentrations in group A were significantly lower than those in group B,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in group A was significantly lower than that in group B,and the difference was statistically significant(P<0.05).Conclusion Compared with iPTH(pg/mL)/80μg,PCT with starting dose of 0.06μg/kg in the treatment of hemodialysis patients with SHPT can significantly relieve SHPT,and the fluctuations of serum calcium and phosphorus are small,and the incidence of adverse reactions is low.There-fore,it is worth applying and popularizing.