西那卡塞联合骨化三醇注射液治疗维持性血液透析患者中重度继发性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注射液治疗维持性血液透析(maintenance hemodialysis,MHD)患者中重度继发性甲状旁腺功能亢进(secondary hyperparathyroidism,SHPT)的效果及安全性.方法 选择2017年1月—2020年1月在我院血液透析室行MHD治疗的中重度SHPT患...

Effect of Cinacalcet Combined with Calcitriol Injection in the Treatment of Patients with Moderate to Severe Secondary Hyperparathyroidism Undergoing Maintenance Hemodialysis

Objective To observe the effect and safety of cinacalcet combined with calcitriol injection in the treatment of moderate to severe secondary hyperparathyroidism(SHPT)in patients undergoing maintenance hemodialysis(MHD).Methods Forty-eight patients with moderate to severe SHPT who were treated with maintenance hemodialysis in Dialysis Center of our hospital from January 2017 to January 2020,were randomly divided into observation group(n=24)and control group(n=24)according to different treatment methods.The control group was given calcitriol injection,and in the observation group was given cinacalcet combined with calcitriol injection.After continuous treatment for 6 months,we observed the change of serum total iPTH,serum calcium(Ca),serum phosphorus(P),the alkaline phosphatase(ALP),β-Ⅰcollagen C-terminal peptide(β-CTX),Ⅰprocollagen amino-terminal propeptide(PⅠNP),compliance status of parathyroid gland volume,and observed adverse reactions in the two groups during treatment.Results After treatment,the level of Ca in the control group was increased compared with that before treatment(P<0.05),while Ca was not significantly changed in the observation group(P>0.05).The level of P,iPTH,ALP,β-CTX and PⅠNP in the two groups after treatment were significantly decreased(P<0.01).In the observation group,the level of Ca,P,iPTH,ALP,β-CTX and PⅠNP were significantly decreased compared with the control group(P<0.05 or P<0.01).The compliance rates of iPTH,Ca and P in the observation group after treatment were significantly higher than those in the control group(P<0.05).After treatment,the volume of parathyroid gland in the control group was not significantly changed(P>0.05),but was reduced in the observation group(P<0.01),and the volume of parathyroid gland in the observation group was smaller than that in the control group(P<0.01).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(χ^2=0.105,P=0.745).Conclusion The combination of cinacalcet and calcitriol injection has a significant effect in the treatment of moderate to severe SHPT,which can reduce serum iPTH level,improve calcium and phosphorus metabolism disorder and abnormal bone metabolism,and reduce thyroid volume.Moreover,it has a good safety.