摘要
目的:探究血液透析继发性甲状旁腺功能亢进症(SHPT)患者应用低钙透析液联合活性维生素D治疗对其血清全段甲状旁腺激素(iPTH)及钙磷代谢水平的影响。方法:选择2021年3月—2022年3月上杭县医院收治的78例血液透析SHPT患者为研究对象,按随机数表法将其分为试验组(n=39)和对照组(n=39),对照组给予活性维生素D联合常规透析液治疗,试验组给予活性维生素D联合低钙透析液治疗。比较治疗前后两组血清iPTH、钙磷代谢指标(血钙、血磷和钙磷乘积)、肾功能指标[血肌酐(Scr)、尿素氮(BUN)和尿素清除指数(KT/V)]水平,记录两组治疗6个月期间不良反应发生情况。结果:治疗后,两组iPTH、血磷和钙磷乘积水平均较同组治疗前明显下降,且同一时间试验组低于对照组,差异有统计学意义(P<0.05);治疗后,两组血钙水平均较同组治疗前升高,且同一时间试验组高于对照组,差异有统计学意义(P<0.05)。两组治疗前、治疗后Scr、BUN和KT/V水平比较,差异无统计学意义(P>0.05)。试验组治疗6个月不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论:低钙透析液联合活性维生素D治疗血液透析SHPT患者可有效减少i PTH分泌,进而改善钙磷代谢紊乱,且不良反应少。
Objective:To explore the effect of low calcium dialysate combined with active Vitamin D on serum total parathyroid hormone(iPTH)and calcium and phosphorus metabolism in hemodialysis patients with secondary hyperparathyroidism(SHPT).Method:A total of hemodialysis 78 patients with SHPT admitted to Shanghang County Hospital from March 2021 to March 2022 were selected as the study objects,and they were divided into experimental group(n=39)and control group(n=39)according to random number table method.The control group was treated with active Vitamin D combined with conventional dialysate,and the experimental group was treated with active Vitamin D combined with low calcium dialysate.The serum iPTH,calcium and phosphorus metabolism indexes(calcium,blood phosphorus and calcium phosphorus product),renal function indexes[serum creatinine(Scr),urea nitrogen(BUN)and urea clearance index(KT/V)]between two groups were compared before and after treatment,and the occurrence of adverse reactions between two groups during 6 months of treatment were recorded.Result:After treatment,the iPTH,blood phosphorus and calcium phosphorus product levels in two groups were decreased compared with those before treatment,and at the same time those in the experimental group were lower than those in the control group,the differences were statistically significant(P<0.05);after treatment,the blood calcium levels in two groups were higher than those before treatment,and at the same time that in the experimental group was higher than that in the control group,the differences were statistically significant(P<0.05).There were no significant differences in the levels of Scr,BUN and KT/V between two groups before and after treatment(P>0.05).During 6 months of treatment,the incidence of adverse reactions in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Low calcium dialysate combined with active Vitamin D can effectively reduce the secretion of iPTH in the treatment of hemodialysis patients with SHPT,and then improve the disorder of calcium and phosphorus metabolism,and has less adverse reactions.
作者
王善平
蓝炉山
张秀华
丘珍玉
苏健忠
WANG Shanping;LAN Lushan;ZHANG Xiuhua;QIU Zhenyu;SU Jianzhong(Shanghang County Hospital,Shanghang 364200,China;不详)
出处
《中外医学研究》
2023年第21期5-8,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
