不同给药途经的1,25 (OH)2 VitD3治疗慢性肾衰竭继发甲旁亢的疗效观察

目的 为观察不同给药途经的1,25(OH)_2VitD_3治疗慢性肾衰竭继发甲旁亢的临床疗效。方法 对长期透析的25例继发甲旁亢病人采用口服或静脉注射1,25(OH)_2VitD_3,2ug/次,2次/周,连续观察6月。结果 两种治疗方式均有效,患者血中iPTH均较治疗前有下降,但静脉给药组iPTH下降幅度高于口服给药组且稳定。而口服给药组易发生高钙血症而中断治疗。两种治疗方法对肝功能、碱性磷酸酶及血肌酐均无影响。结论 静脉注射及口服1,25(OH)_2vitD_3治疗慢性肾功能不全并甲状旁腺功能亢进均有效,但后者易出现高钙血症。

Effect of the mode of calcitriol administration on chronic renal failure patients with the secondary hyperparathyroidism

Objective To compare the effect of the mode of calcitriol oral and intravenous in chronic renal failure pat ients with the secondary hypeiparathyroidisrn. Methods 25 chronic renal failure patients with secondary hyperparathyroidism undergo-ing hemodialysis were randomly divided two groups. Group 1: oral calcitriol 2ug twice per week; Group 2: intravenous calcitriol 2ug twice per week. All patients were followed - up for 6 months. Serum Ievels of iPTH, calcium (Ca) , phosphrous(P), and al-kaline phosphatase (AKP) were measured before and each month after treatment. Results Serum iPTH was decreased significantly in Groupl and Group 2. But the chang of iPTH in Group 2 were significant after l highe than those of Group 1. Hypercalcemia was observed more often in Groupl and so the treatment were interrupted. Serum phosphorus levels were more obviously increased in Group 2 than in Groupl. The function of li ver, AKP, serum creatinine had not significant change. Condusioas The oral and intravenous calcitriol administration seems effective in reducing iPTH ,but hypercalcemia was often happen in oral, Serum phosphorus levels were increased in intravenous administration.