降钙素联用骨化三醇冲击治疗MHD患者肾性骨病的疗效

目的观察鲑鱼降钙素序贯联用骨化三醇冲击治疗MHD患者钙磷代谢紊乱及肾性骨病的疗效。方法选择高钙、高磷、高iPTH的MHD患者30例,皮下注射降钙素,每次50U,每周3次,均为透析后使用;3个月后加用骨化三醇冲击治疗,用药期间监测血钙、血磷、ALP以及iPTH的水平变化及肾性骨病症状(皮肤瘙痒、骨痛、肌无力)的缓解情况。结果鲑鱼降钙素治疗后,血钙、血磷较治疗前不同程度下降,同时患者肾性骨病症状(皮肤瘙痒、骨痛、肌无力)较治疗前明显明显缓解;加用骨化三醇冲击治疗后患者血iPTH水平较治疗前明显下降,差异有统计学意义(P0.05);结论鲑鱼降钙素序贯联用骨化三醇冲击治疗能调节钙磷代谢,抑制CKD-MBD患者的iPTH水平,降低骨转换率,改善肾性骨病症状。

Efficacy of calcitonin combined with calcitriol in treatment of renal osteodystrophy in maintenance hemodialysis patients

Objective To investigate the efficacy of combination treatment of calcitonin and calcitriol on renal disorders of calcium and phosphorus metabolism in MHD patients. Methods Thirty MHD patients with high serum level of iPTH,calcium and phosphorus were selected, and calcitonin （50U） hypodermic injection was given three times a week after hemodialysis for 3 months and then calcitriol pulse treatment was used sequentially. Serum levels of iPTH,calcium,phosphorus and ALP were measured, and the symptoms of CKD-MBD such as pruritus of the skin, ostalgia and myasthenia were assessed after treatment. Results The levels of calcium and ALP decreased significantly after treatment with calcitonin （P〈0.05）, The symptoms of CKD-MBD relieved significantly after the treatment （P〈0.05）. The iPTH in the blood level was significantly lower after the treatment with calcitriol （P〈0.05）. Conclusion Combination of calcitonin and calcitriol is effectively for regulating metabolism of calcium and phosphorus, inhibiting the iPTH level in preserving the CKD-MBD and prevent bone loss and improving symptoms of renal asteopathy in MHD patients.