【摘要】：目的:觀察碳酸鑭治療尿毒癥維持性血液透析患者高磷血癥的臨床療效及安全性。方法:選取2012年1月-2016年12月第三軍醫(yī)大學(xué)新橋醫(yī)院和重慶市巴南區(qū)中醫(yī)院的尿毒癥維持性血液透析并發(fā)高磷血癥患者142例,均給予嚼服碳酸鑭咀嚼片治療,起始劑量:血磷為1.78~2.26 mmol/L時(shí),250 mg,tid;血磷2.26 mmol/L時(shí),500 mg,tid。在治療過(guò)程中,根據(jù)患者血磷水平調(diào)整藥物劑量。治療1、2、3個(gè)月后,檢測(cè)患者血磷、血鈣、白蛋白、甲狀旁腺激素(PTH)和堿性磷酸酶水平,計(jì)算校正血鈣及鈣磷乘積,并觀察不良反應(yīng)。結(jié)果:治療1、2、3個(gè)月后,所有患者血磷、鈣磷乘積水平均較治療前顯著下降,差異有統(tǒng)計(jì)學(xué)意義(P0.05);治療3個(gè)月后,血鈣校正濃度較治療前顯著減低,差異有統(tǒng)計(jì)學(xué)意義(P0.05);治療前后,患者血漿白蛋白、堿性磷酸酶、PTH水平比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。患者總有效率為93.7%。有19例患者出現(xiàn)輕微不良反應(yīng)。結(jié)論:碳酸鑭治療尿毒癥維持性血液透析患者高磷血癥具有較高的臨床有效率,能明顯降低患者血磷和鈣磷乘積,且安全性較好。
[Abstract]:Objective: to observe the efficacy and safety of lanthanum carbonate in the treatment of hyperphosphatemia in patients with uremia maintenance hemodialysis. Methods: 142 patients with uremia maintenance hemodialysis complicated with hyperphosphatemia were selected from Xinqiao Hospital of the third military Medical University and Banan Hospital of traditional Chinese Medicine from January 2012 to December 2016. All patients were treated with lanthanum carbonate chewable tablets. The initial dose of plasma phosphorus was 1.78 ~ 2.26 mmol 路L ~ (-1) and that of blood phosphorus was 2.26 mmol / L and 500 mg 路L ~ (-1) 路L ~ (-1) 路L ~ (-1) 路L ~ (-1) 路L ~ (-1) ~ (-1). During the course of treatment, the dosage of the drug was adjusted according to the blood phosphorus level of the patient. The levels of serum phosphorus, serum calcium, albumin, parathyroid hormone (PTH) and alkaline phosphatase (ALP) were measured after treatment for 1 and 3 months. The corrected blood calcium and calcium phosphorus products were calculated and the adverse reactions were observed. Results: after 1 and 3 months of treatment, the levels of serum phosphorus, calcium and phosphorus product in all patients were significantly lower than those before treatment (P0.05), and the corrected serum calcium concentration was significantly lower after 3 months of treatment than that before treatment. The difference was statistically significant (P0.05); before and after treatment, there was no significant difference in plasma albumin and alkaline phosphatase PTH levels (P0.05). The total effective rate was 93. 7%. There were 19 patients with mild adverse reactions. Conclusion: lanthanum carbonate has a high clinical effective rate in the treatment of hyperphosphatemia in patients with uremia maintenance hemodialysis. It can obviously reduce the product of phosphorus and calcium and phosphorus in patients with uremia, and the safety is good.
【作者單位】： 重慶市巴南區(qū)中醫(yī)院內(nèi)二科;第三軍醫(yī)大學(xué)新橋醫(yī)院腎內(nèi)科;
【基金】：國(guó)家自然科學(xué)基金資助項(xiàng)目(No.81400747)
【分類號(hào)】：R692.5

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