西那卡塞片联合阿法骨化醇软胶囊治疗血液透析合并继发性甲状旁腺功能亢进的疗效观察

Efficacy of cinacalcet combined with Alfacalcidol Soft Capsules for the treatment of secondary hyperparathyroidism in patients receiving maintenance hemodialysis

目的观察西那卡塞片联合阿法骨化醇软胶囊治疗维持性血液透析(Hemodialysis,HD)合并继发性甲状旁腺功能亢进(Secondary hyperparathyroidism,SHPT)的疗效。方法选择2020年1月至2022年8月本院血液净化中心行维持性HD同时伴有SHPT患者39例作为治疗组,给予西那卡塞片联合阿法骨化醇软胶囊治疗。选择同期HD合并SHPT患者34例作为对照组,给予HD治疗。比较两组白细胞计数、血红蛋白、血白蛋白、肾脏功能、碱性磷酸酶(Alkaline phosphatase,ALP)、血脂、校正血钙、血磷、血镁、全段甲状旁腺激素(intact Parathyroid hormone,iPTH)和C反应蛋白等指标。结果治疗组ALP、iPTH水平低于对照组,血红蛋白水平高于对照组(P<0.05),而血钙和血磷水平差异无统计学意义(P>0.05)。结论西那卡塞片联合阿法骨化醇软胶囊可有效降低维持性HD合并SHPT患者的ALP、iPTH水平,提高血红蛋白水平,且对血钙、血磷的水平无明显影响。

Objective To investigate the efficacy of cinacalcet combined with Alfacalcidol Soft Capsules for the treatment of secondary hyperparathyroidism(SHPT)in patients receiving maintenance hemodialysis(HD).Methods A total of 39 HD patients with SHPT from January 2020 to August 2022 conducted at blood purification center of our hospital were selected as the treatment group,and received oral cinacalcet combined with Alfacalcidol Soft Capsules.The 34 patients with HD and SHPT in the same period were selected as the control group and treated with HD.The indicators of white blood cell count,hemoglobin,albumin,renal function,alkaline phosphatase,blood lipids,corrected calcium,magnesium,phosphorus,intact parathyroid hormone,C reactive protein were compared between the two groups.Results The levels of alkaline phosphatase and parathyroid hormone in the treatment group were lower than those in the control group,and the level of hemoglobin in the treatment group was higher than that in the control group(P<0.05);while there was no statistically significant difference in blood calcium and phosphorus levels(P>0.05).Conclusion Cinacalcet combined with Alfacalcidol Soft Capsules can reduce alkaline phosphatase and parathyroid hormone levels in HD patients with SHPT,increase hemoglobin levels,and have no significant effect on calcium and phosphorus levels.