活性维生素D联合西那卡塞对MHD甲状旁腺功能亢进患者预后恢复的影响

The Effect of Active Vitamin D Combined with Cinacalcet on the Prognostic Recovery of Patients with MHD Hyperparathyroidism

目的分析活性维生素D联合西那卡塞对维持性血液透析(MHD)甲状旁腺功能亢进(甲旁亢)患者预后恢复的影响。方法选取该院2019年5月—2020年1月收治50例MHD甲旁亢患者为研究对象,按信封法将其分为对照组和观察组,各25例。对照组采取活性维生素D治疗,观察组在对照组基础上联合西那卡塞治疗。比较两组治疗有效率、安全性、生化指标、血浆尿素氮(BUN)及血肌酐(SCR)指标。结果观察组治疗有效率96.00%高于对照组的68.00%,差异有统计学意义(χ^(2)=4.878,P=0.027)。治疗后,观察组血Ga^(2+)、钙磷乘积高于对照组,血P^(3-)、全段甲状旁腺激素(iPTH)低于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率为16.00%与对照组8.00%比较,差异无统计学意义(P>0.05);观察组BUN、SCR指标低于对照组,差异有统计学意义(P<0.05)。结论对MHD甲旁亢患者采取活性维生素D联合西那卡塞治疗效果显著,能有效改善生化指标,安全性较好。

Objective To analyze the effect of active vitamin D combined with cinacalcet on the prognosis of patients with maintenance hemodialysis(MHD)hyperparathyroidism(hyperparathyroidism).Methods 50 patients with MHD hyperparathyroidism admitted to the hospital from May 2019 to January 2020 were selected as the research objects.According to the envelope method,they were divided into control group and observation group with 25 cases each.The control group was treated with active vitamin D,and the observation group was treated with cinacalcet on the basis of the control group.The treatment efficiency,safety,biochemical indexes,plasma urea nitrogen(BUN)and blood creatinine(SCR)indexes were compared between the two groups.Results The effective rate of treatment in the observation group was 96.00%higher than 68.00%of the control group,the difference was statistically significant(χ^(2)=4.878,P=0.027).After treatment,the observation group's blood Ga^(2+),calcium and phosphorus product were higher than those of the control group,and blood P^(3-) and whole parathyroid hormone(iPTH)were lower than those of the control group,the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 16.00%compared with 8.00%in the control group,the difference was statistically significant(P>0.05).The BUN and SCR indexes of the observation group were lower than those of the control group,the difference was statistically significant(P<0.05).Conclusion The therapeutic effect of active vitamin D combined with cinacalcet for patients with MHD hyperparathyroidism is significant,which can effectively improve the biochemical indicators and has good safety.