帕立骨化醇联合西那卡塞、碳酸司维拉姆治疗血液透析患者继发性中重度甲状旁腺功能亢进的效果分析

Effect Analysis of Paricalcitol Plus Cinacalcet and Sevelamer Carbonate in Treatment of Secondary Moderate to Severe Hyperparathyroidism in Hemodialysis Patients

目的:探讨帕立骨化醇联合西那卡塞、碳酸司维拉姆治疗血液透析患者继发性中重度甲状旁腺功能亢进的效果。方法:选取2020年10月—2022年10月蒙阴县人民医院收治的60例血液透析继发性中重度甲状旁腺功能亢进患者作为研究对象,按照治疗方式的不同分为对照组与试验组,各30例。对照组给予阿法骨化醇联合西那卡塞、碳酸司维拉姆治疗,试验组给予帕立骨化醇联合西那卡塞、碳酸司维拉姆治疗。比较两组治疗效果、甲状旁腺指标水平,不良反应发生情况。结果:试验组治疗总有效率高于对照组,差异有统计学意义(P=0.0283)。治疗前,两组甲状旁腺激素(PTH)、血钙、血磷水平比较,差异无统计学意义(P>0.05);治疗后,试验组PTH水平低于对照组,血钙、血磷水平高于对照组,差异有统计学意义(P<0.0001)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:帕立骨化醇联合西那卡塞、碳酸司维拉姆治疗血液透析继发中重度甲状旁腺功能亢进的效果确切,能够明显降低患者PTH水平,具有较高的安全性。

Objective:To investigate the effect of paricalcitol plus cinacalcet and sevelamer carbonate in treatment of secondary moderate to severe hyperparathyroidism in hemodialysis patients.Methods:A total of 60 patients with moderate to severe hyperparathyroidism secondary to hemodialysis who were admitted to Mengyin County People's Hospital from October 2020 to October 2022 were selected as the study subjects.The patients were divided into control group and experimental group according to the difference of treatment method,with 30 cases in each group.The control group was treated with alfacalcidol+cinacalcet+sevelamer carbonate,and the experimental group was treated with paricalcitol+cinacalcet+sevelamer carbonate.The treatment effect,the level of parathyroid gland indexes,and the occurrence of adverse reactions between the two groups were compared.Results:The total effective rate of treatment in the experimental group was higher than that in the control group,and the difference was statistically significant(P=0.0283).Before treatment,there was no statistically significant difference in the levels of parathyroid hormone(PTH),blood calcium and blood phosphorus between the two groups(P>0.05).After treatment,the level of PTH in the experimental group was lower than that in the control group,and the levels of blood calcium and blood phosphorus in the experimental group were higher than those in the control group,and the difference was statistically significant(P<0.0001).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:The treatment of paricalcitol plus cinacalcet and sevelamer carbonate for moderate to severe hyperparathyroidism secondary to hemodialysis has definite effects,it can obviously reduce the PTH level in patients and has higher safety.