摘要
目的:观察司维拉姆联合碳酸钙治疗慢性肾衰竭(CRF)血液透析合并高磷血症患者的效果。方法:回顾性分析2021年12月至2023年6月该院收治的88例CRF血液透析合并高磷血症患者的临床资料,按照治疗方法不同将其分为对照组和观察组各44例。两组均进行基础治疗和血液透析,在此基础上,对照组给予碳酸钙治疗,观察组在对照组基础上联合司维拉姆治疗,两组均持续治疗3个月。比较两组临床疗效,治疗前后肾功能指标[血尿素氮(BUN)、血肌酐(Scr)、内生肌酐清除率(Ccr)]、血钙、血磷、全段甲状旁腺激素(iPTH)水平,以及不良反应发生率。结果:观察组治疗总有效率为88.64%(39/44),高于对照组的68.18%(30/44),差异有统计学意义(P<0.05);治疗后,两组BUN、Scr水平均低于治疗前,且观察组低于对照组,两组Ccr水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);治疗后,两组血钙水平均高于治疗前,且观察组高于对照组,两组血磷、iPTH水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:司维拉姆联合碳酸钙治疗CRF血液透析合并高磷血症患者可提高治疗总有效率和血钙水平,改善肾功能指标水平,降低血磷、iPTH水平,效果优于单纯碳酸钙治疗。
Objective:To observe effects of Sevelamer combined with Calcium carbonate in treatment of chronic renal failure(CRF)hemodialysis patients with hyperphosphatemia.Methods:The clinical data of 88 patients with CRF hemodialysis combined with hyperphosphatemia admitted to this hospital from December 2021 to June 2023 were retrospectively analyzed.According to different treatment methods,they were divided into control group and observation group,44 cases in each group.Both groups received basic treatment and hemodialysis.On this basis,the control group was treated with Calcium carbonate,while the observation group was treated with Sevelamer on the basis of that of the control group.Both groups were treated for 3 months.The clinical efficacy,the levels of renal function indexes[blood urea nitrogen(BUN),serum creatinine(Scr),endogenous creatinine clearance rate(Ccr)],serum calcium,serum phosphorus,and intact parathyroid hormone(iPTH)levels before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 88.64%(39/44),which was higher than 68.18%(30/44)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of BUN and Scr in the two groups were lower than those before the treatment,and those in the observation group were lower than those in the control group;the Ccr levels of the two groups were higher than those before the treatment,and that in the observation group was higher than that in the control group;and the differences were statistically significant(P<0.05).After the treatment,the serum calcium levels of the two groups were higher than those before the treatment,and that in the observation group was higher than that in the control group;the levels of serum phosphorus and iPTH in the two groups were lower than those before the treatment,and those in the observation group were lower than those in the control group;and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Sevelamer combined with Calcium carbonate in the treatment of the CRF hemodialysis patients with hyperphosphatemia can improve the total effective rate of treatment and the serum calcium levels,improve the levels of renal function indexes,and reduce the levels of serum phosphorus and iPTH.Moreover,it is superior to simple Calcium carbonate treatment.
作者
王俊如
WANG Junru(Department of Nephrology of Luoyang First People’s Hospital,Luoyang 471000 Henan,China)
出处
《中国民康医学》
2025年第6期33-35,共3页
Medical Journal of Chinese People’s Health
关键词
司维拉姆
碳酸钙
血液透析
慢性肾衰竭
高磷血症
肾功能
血钙
Sevelamer
Calcium carbonate
Hemodialysis
Chronic renal failure
Hyperphosphatemia
Renal function
Serum calcium
