碳酸镧治疗维持性血液透析患者高磷血症的临床疗效

目的 探讨碳酸镧治疗维持性血液透析患者高磷血症的疗效。方法 选择2014年1月至2015年12月在连云港市第一人民医院维持性血液透析的50例患者为研究对象（透析至少6个月），随机分为碳酸镧组（LC组）和碳酸钙组（CC组），每组各25例，治疗4周、24周后，分别比较两组治疗前后血磷、血钙、甲状旁腺激素水平，24周后两组间钙、磷、甲状旁腺激素水平。结果 47例患者完成治疗及随访。与治疗前相比，两组患者治疗4周后的血磷水平均下降，差异有统计学意义（P<0.05）；与治疗前相比，两组患者治疗24周后的血磷水平下降，差异有统计学意义（P<0.05）。LC组整个治疗过程中血钙无明显变化，差异无统计学意义（P>0.05），而CC组治疗24周后血钙水平升高，差异有统计学意义（P<0.05）。两组患者的甲状旁腺激素水平较治疗前下降，差异有统计学意义（P<0.05）。治疗24周后，LC组患者血磷、血钙、甲状旁腺激素水平低于CC组，差异有统计学意义（P<0.05）。结论 碳酸镧能安全有效治疗终末期肾衰透析患者高磷血症，降磷作用持久、副作用少，且更安全有效。

Effectiveness of lanthanum carbonate in treatment of hyperphosphatemia in maintenance hemodialysis patients

Objective To investigate the effect of lanthanum carbonate on serum phosphorus removal in maintenance hemodialysis (MHD)patients. Methods Fifty patients who reveived maintenance hemodialysis(dialysis at least 6 months) at this hospital from January 2014 to December 2015 were selected for the study. They were randomly divided into lanthanum carbonate group (group LC) and calcium carbonate group (group CC) with 25 cases in each, and then the levels of serum phosphorus, calcium, parathormone(PTH) were compared after treatment for 4 weeks, 24 weeks respectively, as well as calcium, phosphorus, parathyroid hormone levels 24 weeks after treatment. Results Forty-seven patients completed the survey. Compared with those before treatment, the levels of serum phosphorus in LC group and CC group all decreased after 4 weeks treatment (P<0.05); compared with that before treatment, the level of serum phosphate in LC group decreased significantly after 24 weeks treatment (P<0.05), and the level of serum phosphate in CC group decreased significantly after 24 weeks treatment (P<0.05); the serum calcium in LC group did not significantly increase during the whole treatment; however, the serum calcium increased in CC group after 24 weeks treatment, and the difference was statistically significant (P<0.05); the level of PTH in both groups decreased, and the difference was statistically significant (P<0.05). After 24 weeks, the levels of serum phosphate, serum calcium and PTH in LC group were markedly lower than those in CC group (P<0.05). Conclusion Lanthanum carbonate could decrease the levels of serum phosphorus safely and effectively in ESRD patients.