盐酸西那卡塞辅助骨化三醇治疗继发性甲状旁腺功能亢进患者的效果

Effect of Cinacalcet Assisted Calcitriol in the Treatment of Patients with Secondary Hyperparathyroidism

目的:探讨盐酸西那卡塞辅助骨化三醇联合西那卡塞治疗继发性甲状旁腺功能亢进(SHPT)患者的效果。方法:选择本院2020年6月—2021年12月收治的98例因长期血液透析导致SHPT患者,根据随机数字表法分为对照组和观察组,各49例。对照组采用骨化三醇治疗,观察组采用小剂量骨化三醇联合西那卡塞治疗。比较两组治疗前后血钙、血磷、钙磷乘积、血清总碱性磷酸酶(ALP)、血清全段甲状旁腺素(iPTH)、骨密度、肾脏疾病生活质量简表(KDQOL-SF)评分及不良反应发生情况。结果:治疗后,观察组血钙、血磷、钙磷乘积、血清ALP、iPTH水平低于对照组,骨密度水平、KDQOL-SF量表评分高于对照组(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论:SHPT患者经小剂量骨化三醇联合西那卡塞治疗效果显著,可有效降低iPTH水平,维持钙磷及骨代谢平衡,且安全性良好,有助于提高患者生活质量。

Objective:To investigate the effect of cinacalcet assisted calcitriol combined with cinacalcet in the treatment of patients with secondary hyperparathyroidism(SHPT).Methods:A total of 98 patients with SHPT caused by long-term hemodialysis admitted to our hospital from June 2020 to December 2021 were selected and divided into a control group and an observation group according to the random number table method,with 49 cases in each group.The control group was treated with calcitriol,and the observation group was treated with low-dose calcitriol combined with cinacalcet.The blood calcium,blood phosphorus,calciumphosphorus product,serum total alkaline phosphatase(ALP),serum intact parathyroid hormone(iPTH),bone mineral density,kidney disease quality of life short form(KDQOL-SF)score and adverse reactions were compared between the two groups before and after treatment.Results:After treatment,the levels of blood calcium,blood phosphorus,calcium-phosphorus product,serum ALP and iPTH in the observation group were lower than those in the control group,and the level of bone mineral density and KDQOL-SF score were higher than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion:Low-dose calcitriol combined with cinacalcet is effective in the treatment of SHPT,which can effectively reduce iPTH levels,maintain calcium,phosphorus and bone metabolism balance,and has good safety,which is helpful to improve the quality of life of patients.