帕立骨化醇与西那卡塞治疗维持性血液透析患者继发性甲状旁腺功能亢进的疗效和安全性观察

Observation of the Efficacy and Safety of Paricalcitol and Cinacalcet in the Treatment of Secondary Hyperparathyroidism in Maintenance Hemodialysis Patients

目的探究对维持性血液透析继发性甲状旁腺功能亢进患者采用帕立骨化醇和西那卡塞效果。方法于2022年1月至2023年8月选取漯河医学高等专科学校第二附属医院72例维持性血液透析合并继发性甲状旁腺功能亢进患者,运用随机抽签法分为参照组(36例,帕立骨化醇)和试验组(36例,帕立骨化醇联合西那卡塞),对血清免疫活性甲状旁腺素(iPTH)、血钙、血磷、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、高敏C反应蛋白(hs-CRP)、治疗效果以及不良反应进行分析。结果治疗后,试验组iPTH、血钙及血磷水平均低于参照组,差异有统计学意义(P<0.05);治疗后,试验组IL-6、TNF-α和hs-CRP水平均低于参照组,差异有统计学意义(P<0.05);试验组治疗有效率高于参照组,差异有统计学意义(P<0.05);试验组不良反应率低于参照组,差异有统计学意义(P<0.05)。结论帕立骨化醇联合西那卡塞治疗继发性甲状旁腺功能亢进,可抑制甲状旁腺激素合成,改善炎性状态,提升治疗效果,减少不良反应,具有较好的临床应用价值。

Objective To explore the effects of paricalcitol and cinacalcet in patients with secondary hyperparathyroidism undergoing maintenance hemodialysis.Methods From January 2022 to August 2023,72 patients with secondary hyperparathyroidism undergoing maintenance hemodialysis were selected from The Second Affiliated Hospital of Luohe Medical College.They were randomly divided into a reference group(36 cases,treated with paricalcitol)and an experimental group(36 cases,treated with paricalcitol combined with cinacalcet).Serum immunoreactive parathyroid hormone(iPTH),blood calcium,blood phosphorus,interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP),treatment efficacy,and adverse reactions were analyzed.Results After treatment,the levels of iPTH,blood calcium,and blood phosphorus in the experimental group were lower than those in the reference group,with statistically significant differences(P<0.05).After treatment,the levels of IL-6,TNF-α,and hs-CRP in the experimental group were lower than those in the reference group,with statistically significant differences(P<0.05).The treatment efficacy in the experimental group was higher than that in the reference group,with statistically significant differences(P<0.05).The adverse reaction rate in the experimental group was lower than that in the reference group,with statistically significant differences(P<0.05).Conclusion Paricalcitol combined with cinacalcet can inhibit the synthesis of parathyroid hormone,improve inflammatory status,enhance treatment efficacy,and reduce adverse reactions in the treatment of secondary hyperparathyroidism in maintenance hemodialysis patients,showing good clinical application value.