本文關(guān)鍵詞： 西那卡塞 骨化三醇 腎功能不全 甲狀旁腺功能亢進(jìn)癥 繼發(fā)性 甲狀旁腺素　出處：《中國新藥與臨床雜志》2016年09期 　論文類型：期刊論文

【摘要】：目的觀察西那卡塞聯(lián)合骨化三醇治療血液透析患者繼發(fā)性甲狀旁腺功能亢進(jìn)的臨床療效。方法血液透析致繼發(fā)性甲狀旁腺功能亢進(jìn)患者120例,隨機(jī)分為兩組,每組60例。對照組給予骨化三醇治療,初始劑量為0.25μg·d~(-1),每日1次,根據(jù)患者的耐受程度調(diào)整劑量最大至0.5μg·d~(-1),連續(xù)治療3個月;觀察組在骨化三醇治療(同對照組)的同時聯(lián)合西那卡塞治療,初始劑量為25 mg·d~(-1),每日1次,根據(jù)患者的耐受程度調(diào)整劑量最大至50 mg·d~(-1),連續(xù)治療3個月。比較兩組的甲狀旁腺大小、全段甲狀旁腺激素(iPTH)水平、臨床有效率、鈣磷代謝以及殘腎功能指標(biāo)等。結(jié)果觀察組完成58例,對照組完成57例。治療后兩組患者甲狀旁腺的長、寬和厚及iPTH水平均顯著下降(P0.05),且觀察組下降水平更為明顯(P0.05)。觀察組總有效率為95%,高于對照組(67%,P0.05)。治療后兩組患者血鈣水平上升,血磷、鈣磷乘積下降(P0.05),且觀察組上述3項(xiàng)指標(biāo)變化程度均優(yōu)于對照組(P0.05)。治療后兩組血肌酐、尿素氮、堿性磷酸酶和尿素清除指數(shù)均無明顯變化(P0.05),且組間比較無顯著差異(P0.05)。兩組均無嚴(yán)重不良反應(yīng)發(fā)生。結(jié)論西那卡塞聯(lián)合骨化三醇治療血液透析患者繼發(fā)性甲狀旁腺功能亢進(jìn)的臨床療效好,能有效降低PTH水平,維持鈣磷平衡,且患者殘腎功能并無進(jìn)一步惡化。
[Abstract]:Objective To observe the clinical effect of cinacalcet combined with ossification in three alcohol treatment of blood dialysis patients with secondary hyperparathyroidism. 120 cases of patients with secondary hyperparathyroidism caused by hemodialysis methods, were randomly divided into two groups, 60 cases in each group. The control group was given ossification in three alcohol treatment, the initial dose was 0.25 G - d~ (-1) and 1 times a day, according to the tolerance of patients to adjust the dose to a maximum of 0.5 g - d~ (-1), 3 consecutive months of treatment; the observation group in the treatment of ossification in three alcohol (as control group) combined with cinacalcet treatment, the initial dose was 25 mg - d~ (-1), 1 times a day. According to the tolerance dose adjustment in patients with up to 50 mg - d~ (-1), continuous treatment for 3 months. Compared with two groups of parathyroid size, intact parathyroid hormone (iPTH) levels, clinical efficiency, calcium and phosphorus metabolism and residual renal function indexes. Results the observation group 58 cases, control group 57 cases. Two groups of patients after treatment of parathyroid glands, wide and thick and iPTH levels were significantly decreased (P0.05), and the observation group decreased more obvious level (P0.05). The total effective rate of observation group was 95%, higher than the control group (67%, P0.05). Increased serum calcium levels in the two groups after treatment of serum phosphorus, calcium phosphorus product decreased (P0.05), and the observation group of the 3 indicators of changes were better than the control group (P0.05). After treatment, two groups of serum creatinine, urea nitrogen, alkaline phosphatase and urea clearance index showed no significant change (P0.05), and no significant difference between groups (P0.05). No serious adverse reactions in both two groups. Conclusion the curative effect of cinacalcet combined with ossification in three alcohol treatment of blood dialysis patients with secondary hyperparathyroidism, can effectively reduce the PTH level, maintaining calcium and phosphorus balance, and residual renal function in patients with no further deterioration.

【作者單位】： 長治醫(yī)學(xué)院附屬和濟(jì)醫(yī)院腎內(nèi)科;
【分類號】：R692.5;R582.1

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 蔡璐;;骨化三醇治療血液透析患者繼發(fā)性甲狀旁腺功能亢進(jìn)的療效觀察[J];江西醫(yī)藥;2014年06期

2 裴榮光;蘇如松;鄭敏珍;李國;宋慧芳;;骨化三醇對維持性血液透析繼發(fā)性甲狀旁腺功能亢進(jìn)患者心臟的影響[J];疑難病雜志;2009年03期

3 羅中明;付紅英;黃鵬煜;;骨化三醇沖擊治療血透患者繼發(fā)性甲狀旁腺功能亢進(jìn)療效觀察[J];亞太傳統(tǒng)醫(yī)藥;2013年10期

4 侯曉艷;;骨化三醇沖擊治療血透患者繼發(fā)性甲旁亢的療效觀察[J];中國中西醫(yī)結(jié)合腎病雜志;2014年01期

5 余國洪,楊志鵬;骨化三醇對長期維持腹膜透析患者血清鈣 磷水平的影響——附38例臨床分析[J];新醫(yī)學(xué);2004年03期

6 洪虹;苗華;;骨化三醇聯(lián)合低鈣透析在維持性血液透析老年患者中的應(yīng)用——附17例報告[J];新醫(yī)學(xué);2007年07期

7 張有平;;骨化三醇聯(lián)合低鈣透析在維持性血液透析繼發(fā)甲狀旁腺功能亢進(jìn)患者中的應(yīng)用[J];現(xiàn)代實(shí)用醫(yī)學(xué);2009年06期

8 陳今;余毅;孫淑清;王琰;黃睿;;骨化三醇治療血液透析患者繼發(fā)性甲狀旁腺功能亢進(jìn)癥的臨床觀察[J];中國血液凈化;2011年09期

9 吳銳;周凌輝;;小劑量骨化三醇維持治療血液透析病人繼發(fā)性甲旁亢觀察[J];中外醫(yī)療;2011年35期

10 石平;章亮;張玉新;湯小芳;李康峰;周玉坤;;低鈣透析聯(lián)合骨化三醇沖擊治療在維持性血液透析患者繼發(fā)性甲旁亢中的應(yīng)用[J];海南醫(yī)學(xué);2012年06期

相關(guān)會議論文 前1條

1 劉暢;于黔;蔣文勇;吳欣;趙素云;閔亞麗;藍(lán)天座;李曉穎;;骨化三醇沖擊治療聯(lián)合不同血液凈化方式對維持性血液透析患者繼發(fā)性甲狀旁腺功能亢進(jìn)的療效[A];中西醫(yī)結(jié)合學(xué)會腎病專業(yè)委員會2013年學(xué)術(shù)年會暨繼續(xù)教育學(xué)習(xí)班資料匯編[C];2013年

相關(guān)碩士學(xué)位論文 前1條

1 褚小燕;尿毒清顆粒聯(lián)合骨化三醇治療透析患者瘙癢癥的臨床觀察[D];浙江中醫(yī)藥大學(xué);2013年

，

本文編號：1504051