西那卡塞联合骨化三醇注射液在维持性血液透析患者中重度继发性甲状旁腺功能亢进中的应用

Application of Senecase Combined with Calcitriol Injection in Moderate and Severe Secondary Hyperparathyroidism of Maintenance Hemodialysis Patients

目的研究在维持性血液透析(MHD)患者中重度继发性甲状旁腺功能亢进(SHPT)中应用西那卡塞联合骨化三醇注射液治疗的临床效果。方法选取本院2020年1月-2021年7月治疗的72例MHD中重度SHPT患者;依据随机数字表法将72例患者均分为2组,对照组36例应用骨化三醇注射液治疗,观察组36例应用西那卡塞+骨化三醇注射液治疗;比较两组患者的生化指标水平、血清iPTH、Ca、P达标率、甲状旁腺体积及不良反应发生率。结果对比两组各项生化指标[iPTH、Ca、P及ALP、PINP]水平,治疗前未见统计学差异(P>0.05);治疗后观察组均低于对照(t=6.064/2.461/3.737/3.512/2.892,P<0.05)。对比两组血清iPTH、Ca、P达标率,观察组均高于对照组(χ^(2)=6.469/8.867/5.844,P<0.05)。对比两组甲状旁腺体积,治疗前无差异(P>0.05);治疗后观察组小于对照组(t=6.024,P<0.05)。对比两组用药不良反应发生率,无统计学差异(χ^(2)=0.094,P>0.05)。结论在MHD患者中重度SHPT治疗中应用西那卡塞+骨化三醇注射液效果显著,可有效促进各项血生化指标改善,促使甲状旁腺体积减小,且治疗期间不良反应少,安全性高,值得推广。

Objective To study clinical effect of sinacasse combined with calcitriol injection in treatment of moderate and severe secondary hyperparathyroidism(SHPT)of patients with maintenance hemodialysis(MHD).Methods The paper chose 72 patients with moderate and severe SHPT treated with MHD from January 1,2020 to July 31,2021 in our hospital,and divided them into two groups according to random number table method,36 cases in control group were treated with calcitriol injection,and 36 cases in observation group with senecase+calcitriol injection.Level of biochemical indicators,reaching standard rate of serum iPTH,Ca,P,volume of parathyroid gland and adverse reactions incidence was compared between two groups.Results There was no statistical difference between two groups in levels of various biochemical indicators[iPTH,Ca,P,ALP,PINP]before treatment(P>0.05).After treatment,those of observation group were lower than control group(t=6.064/2.461/3.737/3.512/2.892,P<0.05).Standard rate of serum iPTH,Ca and P of observation group was higher than control group(χ^(2)=6.469/8.867/5.844,P<0.05).There was no difference in parathyroid volume between two groups before treatment(P>0.05).After treatment,that of observation group was less than control group(t=6.024,P<0.05).There was no statistical difference in adverse drug reactions incidence between two groups(χ^(2)=0.094,P>0.05).Conclusion In treatment of moderate and severe SHPT of MHD patients,senecase+calcitriol injection can achieve significant effect,improve various blood biochemical indicators effectively,promote reduction of parathyroid volume,with fewer adverse reactions during treatment,high safety,which is worthy of promotion.