碳酸司维拉姆联合血液透析对尿毒症后肾性骨病患者的影响

The Impact of Sevelamer Carbonate Combined with Hemodialysis on Patients with Renal Osteodystrophy after Uremia

目的研究碳酸司维拉姆联合血液透析对尿毒症后肾性骨病患者的影响。方法选取2020年5月至2023年5月上杭县医院收治的65例尿毒症后肾性骨病患者,采用随机数字表法分为对照组(33例)和观察组(32例),对照组进行血液透析治疗,观察组采用碳酸司维拉联合血液透析治疗。比较两组的血清血尿素氮、血肌酐、尿酸、血红蛋白、营养状态评分、炎症指标、血磷、血钙、iPTH、LDL-C、FGF23水平和不良反应。结果治疗后,观察组的血清血尿素氮、血肌酐、尿酸、血红蛋白更低(P<0.05);观察组白蛋白和前白蛋白水平高于对照组(P<0.05);观察组Hs-CRP、IL-6、TNF-α水平更低(P<0.05);观察组血磷、血钙、iPTH、LDL-C、FGF23水平更低(P<0.05);观察组不良反应总发生率更低(P<0.05);观察组躯体疼痛、社会功能、情感职能、生理功能维度评分均高于对照组(P<0.05)。结论碳酸司维拉姆联合血液透析治疗尿毒症后肾性骨病可改善尿毒症后肾性骨病患者临床指标,降低不良反应发生率。

Objective To study the effects of sevelamer carbonate combined with hemodialysis on patients with renal osteodystrophy after uremia.Methods From May 2020 to May 2023,65 patients with renal osteodystrophy after uremia admitted to Shanghang County Hospital were selected and divided into a control group(33 cases)and an observation group(32 cases)using the random number table method.The control group underwent hemodialysis treatment,while the observation group received sevelamer carbonate combined with hemodialysis treatment.The serum levels of blood urea nitrogen,creatinine,uric acid,hemoglobin,nutritional status scores,inflammatory markers,blood phosphorus,blood calcium,iPTH,LDL-C,FGF23 levels,adverse reactions,and quality of life were compared between the two groups.Results After treatment,the serum levels of blood urea nitrogen,creatinine,uric acid,and hemoglobin in the observation group were lower(P<0.05);the levels of albumin and prealbumin in the observation group were higher than those in the control group(P<0.05);the levels of Hs-CRP,IL-6,and TNF-αin the observation group were lower(P<0.05);the levels of blood phosphorus,blood calcium,iPTH,LDL-C,and FGF23 in the observation group were lower(P<0.05);the total incidence of adverse reactions in the observation group was lower(P<0.05);the dimension scores of bodily pain,social function,emotional function,and physical function,as well as the total score of SF-36,in the observation group were higher than those in the control group(P<0.05).Conclusions Sevelamer carbonate combined with hemodialysis treatment for renal osteodystrophy after uremia can improve the clinical indicators of patients with renal osteodystrophy after uremia and reduce the incidence of adverse reactions.