维持性血透患者口服1,25(OH)_2D_3的治疗观察

Therapy effect of 1,25-(OH)_2D_3 on secondary hyperparathyroidism (SHPT) caused by maintenance hemodialysis

目的 观察维持性血透患者的继发性甲状旁腺功能亢进 (SHPT)不同剂量1,25(OH) 2D3 治疗效果。方法 对维持性血透的SHPT患者根据其血清免疫反应性甲状旁腺激素 (iPTH)水平分2组。小剂量组[1,25(OH) 2D3,0.25ug口服 ,1次/d和大剂量组[1,25(OH)2D3,3.0ug口服 ,2次/周。分别观察两组治疗前后血清iPTH、血钙、磷以及伴随的临床症状。结果 小剂量组 :治疗后血清iPTH水平较治疗前有明显下降[(262.76±197.81)pg/MLvs(191.81±144.74)pg/ML,p<0.05] ,血钙上升、血磷下降(p<0.01)。大剂量组 :治疗后血清iPTH水平明显下降[(504.14±387.01)pg/MLvs(182.56±179.47)pg/ML,p<0.01] ,骨痛、皮肤瘙痒等症状明显减轻。结论 口服1,25(OH) 2D3

Objective To investigate the therapy effect of different dosage of 1,25-(OH)2D3 on secondary hyperparathyroidism(SHPT) caused by maintenance hemodialysis. Method Patient of SHPT who need maintenance hemodialysis were divided into 2 groups according to the serum level parathormone(PTH). Patients of group I took 1,25-(OH)2D3 orally at a dosage of 0.25ug/d. Patients of group II took 1,25-(OH)2D3orally at a dosage of 3.0ug/3d.The serum level of parathormone, calcium, phosphorum and concomitant clinical symptom were then observed. Result Group I showed notable decline of PTH and phosphorum and notable increase of calcium. Group II showed notable decline of PTH and alleviation of concomitant clinical symptom such as osteodynia and Itch of skin. Conclusion Oral vitD3(1,25) is a effect therapy for SHPT caused by maintenance hemodialysis.