比较帕立骨化醇与骨化三醇对血液透析患者继发甲状旁腺功能亢进的治疗效果

Comparison of Therapeutic Effects of Paricalcitol and Calcitriol in Patients with Secondary Hyperparathyroidism during Hemodialysis

目的比较帕立骨化醇与骨化三醇对血液透析患者继发性甲状旁腺功能亢进的治疗效果。方法选取2019年1月至2020年12月某院收治的维持性血液透析继发甲状旁腺功能亢进患者80例,采用随机数字表法分2组,各40例,A组采用帕立骨化醇治疗,B组采用骨化三醇治疗,均持续治疗8周。比较治疗前后两组全段甲状旁腺激素水平、碱性磷酸酶水平、血钙水平、血磷水平、钙磷乘积及不良事件的发生情况。结果A组和B组治疗后全段甲状旁腺激素、碱性磷酸酶、血磷均较治疗前下降,差异有统计学意义(均P<0.05),血钙较治疗前升高,差异有统计学意义(均P<0.05),钙磷乘积较治疗前比较,差异无统计学意义(均P>0.05)。治疗后A组全段甲状旁腺激素、碱性磷酸酶、血磷均低于B组,血钙高于B组,差异有统计学意义(均P<0.05)。A组不良事件发生率(7.50%)明显低于B组(25.00%),差异有统计学意义(P<0.05)。结论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疗效优于骨化三醇,不良事件发生率低,安全性更好。

Objective To compare the therapeutic effects of paricalcitol and calcitriol against secondary hyperparathyroidism(SHPT)among patients under hemodialysis.Methods Eighty patients with SHPT undergoing maintenance hemodialysis were randomly divided into two groups:group A(n=40)treated with paricalcitol and group B(n=40)treated with calcitriol.All the patients were treated for 8 weeks.The serum levels of parathyroid hormone,alkaline phosphatase,calcium,phosphorus,calciumphosphorus products,and adverse events were compared between the two groups.Results After treatment,the levels of parathyroid hormone,alkaline phosphatase and phosphorus in both groups were decreased,while the level of calcium was increased(all P<0.05).The levels of parathyroid hormone,alkaline phosphatase and phosphorus in group A were lower than those of group B,but the level of serum calcium was higher(all P<0.05).The incidence of adverse events in group A was significantly lower than that of group B(7.50%vs 25.0%,P<0.05).Conclusion Paricalcitol is superior to calcitriol in the treatment of SHPT during hemodialysis,with better efficacy and safety.