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临床研究

Clinical Study of Paricalcitol in the Treatment of Secondary Hyperparathy⁃roidism in Hemodialysis Patients

目的 探讨血液透析继发甲状旁腺功能亢进患者予帕立骨化醇治疗的效果。方法 选取丹阳市第三人民医院于2020年1月—2022年12月诊治的72例血液透析继发甲状旁腺功能亢进患者为研究对象,以随机数表法分为两组,对照组(n=36)予骨化三醇治疗,观察组(n=36)予帕立骨化醇治疗,治疗12周后评估临床疗效,比较治疗前后钙磷代谢及甲状旁腺素水平,并评估炎症反应状态。结果 观察组总有效率较对照组高,差异有统计学意义(P<0.05)。治疗后观察组血钙(2.31±0.24)mmol/L、血磷(1.84±0.22)mmol/L、甲状旁腺素(365.25±84.61)pg/ml均低于对照组,差异有统计学意义(t=3.635、4.605、7.409,P均<0.05)。治疗后观察组炎症因子水平低于对照组,差异有统计学意义(P<0.05)。结论 对血液透析继发性甲状旁腺功能亢进患者,予帕立骨化醇治疗效果确切,可改善钙磷代谢与甲状旁腺素水平,能减轻炎症反应。

Objective To investigate the effect of paricalcitol on secondary hyperparathyroidism in hemodialysis pa-tients.Methods A total of 72 patients with secondary hyperparathyroidism diagnosed and treated in Danyang Third People's Hospital from January 2020 to December 2022 were selected as the study objects and were divided into two groups by random number table method.The control group(n=36)was treated with calcitriol,and the observation group(n=36)was treated with paricalcitol.The clinical efficacy was evaluated after 12 weeks of treatment.Calcium and phosphorus metabolism and parathyroid hormone levels were compared before and after treatment,and inflamma-tory response was evaluated.Results The total effective rate of the observation group was higher than that of the con-trol group,the difference was statistically significant(P<0.05).After treatment,blood calcium(2.31±0.24)mmol/L,blood phosphorus(1.84±0.22)mmol/L and parathyroid hormone(365.25±84.61)pg/mL in observation group were lower than those in control group,the differences were statistically significant(t=3.635,4.605,7.409,all P<0.05).Af-ter treatment,the level of inflammatory factors in observation group was lower than those in control group,the differ-ence was statistically significant(P<0.05).Conclusion In patients with secondary hyperparathyroidism caused by he-modialysis,palicalcitol can improve calcium and phosphorus metabolism and parathyroid hormone levels,and reduce inflammation.