摘要
目的探讨盐酸西那卡塞及阿法骨化醇治疗血液透析并发甲状旁腺功能亢进效果。方法选取139例血液透析并发甲状旁腺功能亢进患者作为研究对象,按照随机数字表法分为观察组(n=70)和对照组(n=69),对照组采用阿法骨化醇治疗,观察组在对照组基础上加用盐酸西那卡塞治疗,比较2组患者的治疗效果。结果治疗前,2组患者各项血清指标[血钙、血磷、钙磷乘积、血清全段甲状旁腺素(iPTH)、骨特异性碱性磷酸酶(BSAP)、成纤维细胞生长因子23(FGF23)]比较,差异无统计学意义(P>0.05);治疗后,观察组与对照组患者血钙[(2.69±0.30)mmol·L^(-1)vs(2.19±0.29)mmol·L^(-1)]、血磷[(1.04±0.05)mmol·L^(-1)vs(1.68±0.08)mmol·L^(-1)]、钙磷乘积水平[(48.75±5.24)mg·dL^(-1)vs(43.41±5.06)mg·dL^(-1)]、血清iPTH[(131.20±16.58)ng·L^(-1)vs(312.30±34.65)ng·L^(-1)]、BSAP[(389.60±105.47)U·L^(-1)vs(609.85±163.39)U·L^(-1)]、FGF23[(453.67±115.64)ng·L^(-1)vs(745.31±201.33)ng·L^(-1)]比较,差异有统计学意义(P<0.05)。治疗前,2组患者甲状腺旁体积比较,差异无统计学意义(P>0.05);治疗后,观察组患者甲状腺旁体积(61.48±6.63)mm^(3),小于对照组的(135.72±8.23)mm^(3),差异有统计学意义(P<0.05)。2组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论盐酸西那卡塞及阿法骨化醇治疗血液透析并发甲状旁腺功能亢进效果较好,可改善血清指标及甲状腺肿大。
Objective To investigate the efficacy of cinacalcet hydrochloride and alfacalcidol in the treatment of hemodialysis complicated with hyperparathyroidism.Methods A total of 139 patients with hemodialysis complicated with hyperparathyroidism were selected as the research objects,and were divided into observation group(n=70)and control group(n=69)according to the random number table method.The control group was treated with alfacalcidol,and the observation group was additionally treated with cinacalcet hydrochloride based on the control group.Then the therapeutic effects of the two groups were compared.Results Before treatment,the serum indexes including serum calcium,serum phosphorus,calcium and phosphorus product,serum complete parathyroid hormone(iPTH),bone-specific alkaline phosphatase(BSAP)and fibroblast growth factor 23(FGF23)showed no statistically significant differences between the two groups(P>0.05).After treatment,there were statistical differences between the control group and the observation group on the following indicators(P<0.05):serum calcium[(2.69±0.30)mmol·L^(-1)vs(2.19±0.29)mmol·L^(-1)],blood phosphorus[(1.04±0.05)mmol·L^(-1)vs(1.68±0.08)mmol·L^(-1)],calcium and phosphorus product level[(48.75±5.24)mg·dL^(-1)vs(43.41±5.06)mg·dL^(-1)],serum iPTH[(131.20±16.58)ng·L^(-1)vs(312.30±34.65)ng·L^(-1)],BSAP[(389.60±105.47)U·L^(-1)vs(609.85±163.39)U·L^(-1)]and FGF23[(453.67±115.64)ng·L^(-1)vs(745.31±201.33)ng·L^(-1)].Before treatment,there was no significant difference in the parathyroid volume between the two groups(P>0.05);after treatment,the parathyroid volume of the observation group was(61.48±6.63)mm^(3),which was smaller than that of the control group(135.72±8.23)mm^(3),and the difference was statistically significant(P<0.05).Conclusion Cinacalcet hydrochloride combined with alfacalcidol has a good curative effect in the treatment of hemodialysis complicated with hyperparathyroidism,and can improve serum indexes and goiter.
作者
梁冰
LIANG Bing(Department of Kidney Transplantation Nephrology, Zhengzhou Seventh People’s Hospital, Zhengzhou Henan 450017,China)
出处
《河南医学高等专科学校学报》
2022年第3期266-269,共4页
Journal of Henan Medical College
