帕立骨化醇治療終末期腎臟病繼發(fā)性甲狀旁腺功能亢進(jìn)癥的系統(tǒng)評價(jià)
本文選題:帕立骨化醇 + 繼發(fā)性甲狀旁腺功能亢進(jìn)癥; 參考:《吉林大學(xué)》2014年碩士論文
【摘要】:目的:系統(tǒng)評價(jià)帕立骨化醇治療終末期腎臟病繼發(fā)性甲狀旁腺功能亢進(jìn)癥的安全性及有效性。 方法:應(yīng)用計(jì)算機(jī)檢索Pubmed數(shù)據(jù)庫、Embase數(shù)據(jù)庫、Cochrane圖書館對照試驗(yàn)的中心資料庫、萬方數(shù)據(jù)庫、重慶維普數(shù)據(jù)庫、相關(guān)期刊論文(CNKI),時(shí)間截止至2013年12月。收集帕立骨化醇治療ESRD繼發(fā)性甲狀旁腺功能亢進(jìn)癥的隨機(jī)對照試驗(yàn),應(yīng)用Rev Man5.2軟件對數(shù)據(jù)進(jìn)行Meta分析。 結(jié)果:共納入文獻(xiàn)6篇,共564例患者。研究結(jié)果顯示:有效性分析:帕立骨化醇組iPTH達(dá)標(biāo)率高于活性維生素D組[RR=1.15,,95%CI(1.02,1.29),P=0.02]。帕立骨化醇組iPTH下降幅度大于活性維生素D組,但無統(tǒng)計(jì)學(xué)意義[WMD=-8.36,95%CI(-20.17,3.46),P=0.17]。安全性分析:帕立骨化醇組高鈣血癥發(fā)生率小于活性維生素D組[RR=0.45,95%CI(0.30,0.66),P<0.0001]。帕立骨化醇組鈣磷乘積升高幅度小于活性維生素D組[WMD=-0.06,95%CI(-0.09,-0.03),P=0.0003]。帕立骨化醇組與活性維生素D組高磷血癥發(fā)生率、血清鈣、磷變化幅度相似(P>0.05)。 結(jié)論:與活性維生素D相比,帕立骨化醇可以有效地降低iPTH,提高iPTH的達(dá)標(biāo)率。同時(shí),帕立骨化醇可降低高鈣血癥,鈣磷乘積升高等不良反應(yīng)的發(fā)生率。
[Abstract]:Objective: to evaluate the safety and efficacy of parathyroid alcohol in the treatment of secondary hyperparathyroidism in end-stage renal disease. Methods: the Pubmed database, Embase database, Wanfang database, Chongqing Weipu database, Chinese periodical full-text database were searched by computer, and the time was up to December 2013. A randomized controlled trial of parathyroid in the treatment of ESRD secondary hyperparathyroidism was performed with Rev Man5.2 software. Results: a total of 564 patients were included in 6 articles. The results showed that: the efficiency analysis showed that the iPTH reached the standard rate of parthenol group was higher than that of active vitamin D group. The decrease of iPTH in parietol group was greater than that in active vitamin D group, but there was no statistical significance [WMD-8.36 ~ 95CI-20.17 ~ 3.46 ~ 0.17]. Safety analysis: the incidence of hypercalcinemia in parthenol group was lower than that in active vitamin D group [RRX 0.4595%] (P < 0.0001). The increasing range of calcium and phosphorus product in parthenol group was less than that in active vitamin D group [WMD-0.0695]. The incidence of hyperphosphatemia, the changes of serum calcium and phosphorus in parietol group and active vitamin D group were similar (P > 0.05). Conclusion: compared with active vitamin D, parthenol can effectively reduce iPTH and improve the rate of iPTH. At the same time, parthenol reduced the incidence of adverse reactions such as hypercalcemia and increased calcium and phosphorus product.
【學(xué)位授予單位】:吉林大學(xué)
【學(xué)位級別】:碩士
【學(xué)位授予年份】:2014
【分類號】:R692;R581.1
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