帕立骨化醇治疗血液透析患者继发性甲状旁腺功能亢进的临床研究

Clinical Study of Paricalcitol in the Treatment of Secondary Hyperparathyroidism in Hemodialysis Patients

目的探讨接受血液透析治疗后出现继发性甲状旁腺功能亢进情况的患者予以帕立骨化醇治疗的影响。方法研究时间于2020年8月—2021年8月,研究对象方便选择于该院接受血液透析治疗后出现继发性甲状旁腺功能亢进的患者76例,根据单双号法分作观察组(38例,单号)与对照组(38例,双号),对照组采用骨化三醇治疗,观察组采用帕立骨化醇治疗,对比临床治疗效果,检测两组患者治疗前后血清矿物质浓度及甲状旁腺素,对比两组患者治疗后症状改善情况,和治疗后不良反应总发生率。结果观察组治疗总有效率97.37%高于对照组,差异有统计学意义(χ^(2)=7.370,P<0.05)。两组患者治疗前检测血清矿物质浓度、甲状旁腺素等指标差异无统计学意义(P>0.05),治疗后观察组患者血清钙(Ca)检测结果高于对照组,测得血清磷(P)、血清碱性磷酸酶(ALP)水平相比对照组较低,差异有统计学意义(P<0.05)。另外,观察组患者治疗后甲状旁腺素明显低于对照组,同时皮肤瘙痒、骨痛、乏力症状患者占比明显低于对照组,差异有统计学意义(P<0.05)。观察组患者发生不良反应(恶心呕吐、血压升高、继发性高钙血症)总发生率低于对照组,差异有统计学意义(P<0.05)。结论血液透析治疗后继发性甲状旁腺功能亢进患者采取帕立骨化醇治疗更具良好效果,能够稳定患者血清矿物质浓度,改善甲状旁腺素水平,安全性高,提倡应用推广。

Objective To investigate the effect of paricalcitol treatment on patients with secondary hyperparathyroidism after receiving hemodialysis treatment.Methods The study was established from August 2020 to August 2021.The research subjects conveniently selected 76 patients with secondary hyperparathyroidism after receiving hemodialysis treatment in our hospital.According to the odd and even number method,they were divided into observation group(38 cases,odd number)and control group(38 cases,double number).The control group was treated with calcitriol,and the observation group was treated with paricalcitol.The clinical treatment effects were compared,and the serum mineral concentration and parathyroid hormone were detected in the two groups before and after treatment.The symptom improvement and total incidence of adverse reactions after treatment in the two groups were compared.Results The total effective rate of the observation group was 97.37%higher,than that of the control group,the difference was statistically significant(χ^(2)=7.370,P<0.05).Before treatment,there was no statistically significant difference in serum mineral concentration,parathyroid hormone and other indicators between the two groups(P>0.05).After treatment,the serum Ca test results of the observation group were higher than those of the control group,and the measured P and ALP were lower than those of the control group,the difference was statistically significant(P<0.05).In addition,the parathyroid hormone in the observation group after treatment was significantly lower than that in the control group,and the proportion of patients with skin itching,bone pain,and fatigue symptoms was significantly lower than that in the control group,the difference was statistically significant(P<0.05).The total incidence of adverse reactions(nausea and vomiting,increased blood pressure,secondary hypercalcemia)in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Paricalcitol is more effective for patients with secondary hyperparathyroidism after hemodialysis treatment,which can stabilize the serum mineral concentration and improve the level of parathyroid hormone.It is safe,and its application and promotion are recommended.