西那卡塞联合骨化三醇治疗慢性肾衰竭透析患者继发甲状旁腺功能亢进的效果观察

目的观察西那卡塞联合骨化三醇治疗慢性肾衰竭(chronic renal failure,CRF)透析继发甲状旁腺功能亢进(secondary hyperparathyroidism,SHPT)患者的效果。方法选取东莞市第八人民医院血液净化中心收治的28例CRF继发SHPT的患者作为研究对象,依据随机数字表法分为观察组(n=14)及对照组(n=14),两组均给予透析治疗,对照组采用骨化三醇大剂量间歇疗法(也称冲击治疗),观察组在对照组的基础上联合西那卡塞治疗,治疗3个月后,比较两组血钙、血磷及全段甲状旁腺激素(intact parathyroid hormone,iPTH)水平及不良反应发生情况。结果治疗后,观察组血钙、血磷、iPTH及钙磷乘积均明显优于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论西那卡塞联合骨化三醇治疗CRF透析SHPT患者,可有效改善其血钙、血磷及iPTH水平,且不会增加不良反应。

Analysis of effects of cinacalcet combined with calcitriol in treatment of secondary hyperparathyroidism in dialysis patients with chronic renal failure

Objective To observe effects of cinacalcet combined with calcitriol in treatment of secondary hyperparathyroidism(SHPT) in dialysis patients with chronic renal failure(CRF). Methods 28 patients with CRF secondary to SHPT treated by the blood purification center of Dongguan eighth people’s Hospital were selected as the research objects, and were divided into observation group(n=14) and control group(n=14) according to the random number table method. Both groups were given dialysis treatment. Besides, the control group was treated with high-dose intermittent treatment of calcitriol(also called pulse therapy), while the observation group was given cinacalcet on the basis of that of the control group. 3 months later, the levels of blood calcium, blood phosphorus, and intact parathyroid hormone(iPTH) as well as adverse reactions were compared between the two groups. Results After the treatment, the levels of blood calcium, blood phosphorus and iPTH as well as the calcium-phosphorus product of the observation group were significantly better than those of the control group, and the differences were statistically significant(P<0.05). Conclusions Cinacalcet combined with calcitriol in the treatment of the dialysis patients with CRF secondary to SHPT can effectively improve their blood calcium, blood phosphorus, and iPTH levels without increasing adverse reactions.