鲑鱼降钙素对血透患者肾性骨病的疗效观察

目的观察鲑鱼降钙素(密钙息)皮下注射对长期血透患者并发肾性骨病的疗效.方法选择伴有不同程度骨关节疼痛、关节活动功能减退、血钙升高及转移性钙化伴皮肤瘙痒的14例维持性血透(HD)患者,血透年限6～15年(平均10.7).密钙息注射液50 U第1周皮下注射,1次/d,以后2～3次/周,于透析后使用,疗程3个月.同时低盐低嘌呤饮食,止痛剂停服,定期复查血清钙和磷,部分患者定量计算机扫描检查腰椎骨密度.结果密钙息治疗后血钙、血磷、PTH均有不同程度的降低;骨密度升高(n=4).密钙息治疗后所有患者骨关节疼痛、皮肤瘙痒、关节功能障碍明显好转,13例患者症状在用药后2～3 d开始改善,12例疗程结束后症状基本消失.结论密钙息治疗长期血透患者肾性骨病的疗效显著,可以迅速缓解骨关节疼痛等症状,对防止转移性钙化有一定作用.

Efficacy of salmon calcitonin in treatment of renal osteodystrophy

Objective To study the effect iveness of salmon calcitonin (Miacalcic) in treatment of renal osteodystrophy in patients undergoing long-term hemodialysis (HD) .Methods Fourteen HD patients with bone pain joint dysfunction, hypercalcemia metastatic calcification, skin pruritus were enrolled. The duration of HD ranged from 6-15 years (mean 10.7 years). All patients were treated with HD or HDF, low sodium and purine diet. Any analgesic was ceased. Miacalcic 50u was subcutaneously injected one/day in the first week, then 2-3 times a week after dialysis. The total course was 3 months. Serum calcium and phosphate were monitored. Quantitative computer tomography of lumbar vertebrae was performed in 4 patients. Results The serum calcium, phosphor and PTH levels decreased to different extents, separately after the treatment with Miacalcic. At the same time, The symptoms of renal osteopathy, such as bone pain and joint dysfunction were significantly improved, and bone mineral density of lumbear vertebrae increased in 4 patients. Only one patient stopped Miacalcic administration after 2 weeks treatment. Few side effects were observed. Conclusion Miacalcic for treating renal osteodystrophy in patients on long-ferm hemodialysis is remarkably efficacious.