摘要
目的观察西那卡塞辅助治疗血液透析继发性甲状旁腺功能亢进(SHPT)患者的临床疗效及安全性。方法选取2013年3月—2015年12月湖北省黄石市爱康医院肾内科确诊且住院治疗的血液透析后SHPT患者98例作为研究对象,采用单盲数字随机法分为观察组49例(西那卡塞联合骨化三醇冲击治疗)和对照组49例(规范骨化三醇冲击治疗),对比分析2组治疗3个月后临床疗效、实验室指标[血钙、血磷、钙磷乘积、甲状旁腺激素(iPTH)]、甲状旁腺体积及不良反应。结果观察组总有效率为95.92%(47/49)高于对照组的81.64%(40/49)(χ~2=5.018,P=0.25);治疗3个月后,对照组的血清钙为(2.29±0.26)mmol/L,钙磷乘积为(45.98±6.27)mg/dl,观察组的血清钙为(2.61±0.27)mmol/L,钙磷乘积为(47.65±6.41)mg/dl,观察组较对照组明显升高(t=2.786、6.178,P<0.05);全段甲状旁腺激素观察组为(129.45±25.87)pg/ml、血磷为(1.03±0.06)mmol/L,对照组为(307.25±36.45)pg/ml、(1.65±0.08)mmol/L,观察组较对照组明显降低(t=10.986,P=0.000;t=3.015,P=0.034);治疗后2组甲状旁腺体积均明显缩小,且观察组明显小于对照组[(59.97±6.41)mm^3 vs.(129.37±8.58)mm^3,t=19.846,P=0.000];观察组药物不良反应率为4.08%(2/49),低于对照组的18.37%(9/49)差异有统计学意义(χ~2=5.018,P=0.025)。结论西那卡塞辅助治疗血液透析后SHPT可促进iPTH降低及甲状旁腺体积缩小,不良反应少,值得临床推广。
Objective To observe the clinical efficacy and safety of sensipar in the treatment of secondary parathyroid function（SHPT） in hemodialysis patients.Methods 98 cases of SHPT patients after hemodialysis in the Department of Nephrology Hubei Huangshi Aikang Hospital from March 2013 to December 2015 and were selected,according to single blind digital random method,the cases were divided into study group（sensipar combined with calcitriol pulse therapy,49 cases）and control group（standard calcitriol pulse therapy,49 cases）,the clinical efficacy,laboratory indexes and adverse reactions after 3 months treatment were compared and analyzed in two months.Results The total efficiency of observation group was95.92%（47/49）,which was higher than that of the control group 81.64%（40/49）（χ~2=5.018,P =0.25）;after 3months of treatment,control groups serum calcium was（2.29 ±0.26） mmol/L,calcium and phosphorus product was（45.98±6.27） mg/dl,observation groups serum calcium was（2.61 ±0.27） mmol/L,calcium and phosphorus product was（47.65±6.41） mg/dl,the observation group was significantly higher than that of control group（t =2.786,I =6.178,P〈0.05）;intact parathyroid hormone（iPTH） was（129.45 ±25.87） pg/ml,blood phosphorus（1.03 ＋0.06） mmol/L in the control group,intact parathyroid hormone（iPTH） was（307.25 ±36.45） pg/ml,blood phosphorus（1.65 ±0.08） mmol/L,the observation group was significantly lower than the control group（t =10.986,P = 0.000;t =3.015,P =0.034）;the 2groups after treatment,parathyroid gland volume was significantly reduced,and the observation group（59.97 ±6.41） mm^3was significantly less than the control group（129.37 ±8.58） mm^3（t=19.846,P = 0.000）;observation group s adverse reactions of drugs was 4.08%（2/49）,which was lower than that of the control group＇s 18.37%（9/49）（χ~2= 5.018,P =0.025）.Conclusion Sensipar assisted treatment of hemodialysis SHPT can promote the iPTH and reduce the size of the parathyroid gland,less adverse reactions,it is worthy of clinical promotion.
出处
《疑难病杂志》
CAS
2016年第12期1242-1245,共4页
Chinese Journal of Difficult and Complicated Cases
