西那卡塞联合骨化三醇对维持性血液透析患者继发性甲状旁腺功能亢进的疗效

目的 研究西那卡塞联合骨化三醇对维持性血液透析（MHD）患者继发性甲状旁腺功能亢进(SHPT)的疗效。方法 选取我院收治MHD患者伴SHPT76例，随机分为两组，每组38例。对照组给予西那卡塞治疗，观察组予西那卡塞联合骨化三醇治疗。收集治疗前、治疗后6个月患者的血钙（Ca）、血磷（P）、钙磷乘积（Ca×P）、全段甲状旁腺激素（iPTH）、碱性磷酸酶（ALP）、血肌酐（SCr）等指标的变化。结果 两组治疗后血钙、血磷、钙磷乘积、iPTH及ALP水平均较治疗前明显下降（P<0.05）；观察组较对照组在血磷、钙磷乘积、iPTH水平下降方面更为显著（P<0.05）；观察组的总体有效率明显高于对照组（P<0.05）。结论 西那卡塞联合骨化三醇治疗MHD伴SHPT，能够有效缓解患者的钙磷代谢异常，降低iPTH水平，疗效肯定、安全性好。

Effects of cinaclcetcombined with calcitriol on secondary hyperparathyroidism inpatients with maintenance hemodialysis

Objective To study the effects of cinaclcet combined with calcitriol on secondary hyperparathyroidism(SHPT) in patients with maintenance hemodialysis(MHD).Methods Totally 76 MHD patients with SHPT were included and randomly divided into two groups, with 38 patients in each group.The control group was given cinaclcet, while the observation group was given cinaclcet combined with calcitriol. Before and 6 months after treatment, the changes of bloodcalcium(Ca), phosphorus(P), calcium phosphorus(Ca×P) product, intact parathyroid hormone(iPTH), alkaline phosphatase(ALP), serum creatinine(SCr) and others indexes were measured.Results After treatment, the levels of Ca, P, Ca×P product, iPTH and ALP significantly decreased in two groups(P<0.05). And levels of P, Ca×P productand iPTH in observation group decreased more significantly than those in control group (P<0.05).The total effective rate of observation group was higher than that of control group (P<0.05).Conclusion Cinaclcet combined with calcitriol can effectively alleviate the abnormal calcium and phosphorus metabolism and reduce the level of iPTH in the treatment of MHD patients with SHPT.The therapy has obvious curative effect and high safety.