不同制剂密钙息联合骨化三醇治疗血液透析患者的肾性骨病的疗效分析

目的：观察不同制剂密钙息联合骨化三醇对血液透析导致肾性骨病患者的治疗效果。方法：选择血液透析导致肾性骨病伴高甲状旁腺素（PTH）、高磷血症同时伴有临床症状的患者106例,按照前瞻随机和对照的研究方法分为治疗组与对照组,每组各53例,对所有患者除治疗基础疾病、透析（血液或腹膜透析）、补充钙剂外,治疗组给予密钙息鼻喷剂联合骨化三醇：密盖息鼻喷剂200 IU,前2周每天1次,后隔天1次。3个月为一疗程；对照组给予密钙息肌注联合骨化三醇：密盖息注射液50 IU,肌肉注射,前2周每天1次,第3、4周隔日1次,后每周2次。3个月后观察各组治疗前后肾性骨病症状及血磷、血钙、PTH改变。结果：治疗后,两组肾性骨病相关症状明显好转,血磷、血PTH明显下降,血钙升高；治疗组治疗前血清钙、血清磷和PTH分别为（2.04±0.27）、（2.78±0.31）、（858.50±119.98）,治疗后分别为（2.36±0.19）、（2.18±0.21）、（719.79±120.14）；对照组治疗前血钙、血磷水平、PTH分别为（2.11±0.39）、（2.87±0.23）、（891.45±124.73）,治疗后分别为（2.39±0.34）、（2.19±0.13）、（721.69±117.56）。两组上述指标治疗前后比较差异有统计学意义（P〈0.05）,但两组间比较差异无统计学意义（P〉0.05）；两组骨痛症状均改善明显,但治疗组在缓解时间上优于对照组,差异有统计学意义（P〈0.05）；且治疗组副作用较少。结论：密钙息对肾性骨病治疗鼻喷剂副作用少,更为简便、实用、耐受性好,并可以迅速缓解骨痛。

Analysis of Different Formulations of Miacalcic Combined with Ossification in Three Alcohol for Treatment of Hemodialysis Patients with Renal Osteodystrophy

Objective： To observe the different preparations miacalcic combined with ossification in three alcohol for hemodialysis in patients with renal osteodystrophy treatment effect.Method：106 patients who got the renal bone disease with higher parathyroid hormone （PTH） and hyperphosphatemia caused by hemodialysis were selected, and at the same time, they presented with clinical symptoms, and were divided into the treatment group and the control group according to the research methods of prospectie randomized and controlled, 53 cases in each group, all the patients in the treatment of the underlying disease, dialysis （blood or peritoneal dialysis）, complement calcium and Calcitriol; the treatment group was given Calcitonin nasal spray 200 IU, 1 times a day before 2 weeks, then 1 times on alternate days, 3 months for a course. The control group was given Miacalcic injection 50 IU, intramuscular injection, 1 times a day before 2 weeks, 1 times on alternate days in 3 and 4 weeks, then 2 times a week. After 3 months, the changes of renal osteopathy symptoms and serum phosphorus, serum calcium, PTH of two groups before and after treatment were observed.Result：After the treatment, symptoms of renal osteodystrophy was improved significantly, serum phosphorus, serum PTH decreased significantly, serum calcium level, the treatment group before treatment, serum calcium, phosphorus, parathyroid hormone （PTH） were （2.04±0.27）, （2.78±0.31）, （858.50±119.98）, after treatment were （2.36±0.19）, （2.18±0.21）, （719.79±120.14）; the control group before treatment were （2.11±0.39）, （2.87±0.23）, （891.45±124.73）, after treatment were （2.39±0.34）, （2.19±0.13）, （721.69±117.56）; serum calcium, serum phosphorus and PTH were changed significantly before and after treatment in both groups （P〈0.05）, but no significant differences were observed between the two groups （P〉0.05）; the pain symptoms of two groups were improved obviously, but in the relief time, the trea