骨化三醇治疗慢性肾脏病继发性甲状旁腺功能亢进的疗效

目的探讨骨化三醇冲击治疗慢性肾脏病继发性甲状旁腺功能亢进的临床疗效。方法根据血清全段甲状旁腺激素(iPTH)水平选择尚未进入替代治疗的慢性肾脏病(CKD 4、5期)65例,比较治疗前及治疗后4、8、12周的iPTH、血钙、血磷的变化及临床症状的缓解情况。结果 65例患者经治疗12周后,血清iPTH水平明显下降,与治疗前比较差异具有统计学意义(P<0.05)。患者的血钙较治疗前有上升趋势,而血磷有下降趋势。在治疗8、12周时,患者的Ca2+×P3-明显低于治疗前,差异具有统计学意义(P<0.05)。临床症状有不同程度改善,72.3%患者症状明显改善。结论骨化三醇口服治疗慢性肾脏病合并继发性甲状旁腺功能亢进的非透析患者疗效显著,临床症状改善明显。

Clinical observation on patients with chronic kidney disease and secondary hyperparathyroidism treated by calcitriol

Objective To evaluate the efficacy of calcitriol on patients with chronic kidney disease and secondary hyperparathyroidism.Methods 65 cases of chronic kidney disease patients w ho had tentered alternative therapy w ith elevated intactparathyroid hormone were,the serum concentration of iPTH,change of calcium and phosphorus,the remission degree of clinical symptoms were tested before and at the 4th,8th and 12th week after calcitriol treatment.Results After 12 week-treatment,the serum iPTH level decreased significantly(P < 0.05),the serum calcium had an upw ard trend and the serum phosphorus concentration had a dow nw ard trend.After the treatment for 8 and 12 weeks,the Ca2 + × P3-w as significantly low er(P < 0.05).The clinical symptoms had been improved,the clinical effective rate was 72.3%.Conclusion Oral calcitriol has obvious effect on patients with secondary hyperparathyroidism without hemodialysis,it is worthy of popularization.