碳酸镧联合阿法骨化醇治疗维持性腹膜透析患者继发甲状旁腺功能亢进的临床效果观察.docVIP

碳酸镧联合阿法骨化醇治疗维持性腹膜透析患者继发甲状旁腺功能亢进的临床效果观察 　　[摘要] 目的 观察碳酸镧联合阿法骨化醇治疗维持性腹膜透析患者继发甲状旁腺功能亢进的效果。 方法 选取30例维持性非卧床腹膜透析继发甲状旁腺功能亢进患者，随机分为对照组（n=15，阿法骨化醇 0.5 μg/d）和治疗组（n=15，阿法骨化醇0.5 μg、1次/d+碳酸镧500 mg、3次/d），观察治疗前及治疗后连续3个月的血Ca2+、血P3+及血全段甲状旁腺激素（iPTH）水平变化。 结果 对照组治疗2、3个月后，仅血Ca2+有明显改善（P0.05）。治疗组的血P3+于治疗后1个月开始下降，血Ca2+、血iPTH于治疗后2个月开始有显著改善（P0.05）；与对照组治疗3个月相比，治疗组血P3+、血iPTH改善明显，差异有统计学意义（P0.05）。 结论 在阿法骨化醇基础上加用碳酸镧可明显改善维持性腹膜透析患者钙磷代谢紊乱，有效缓解继发甲状旁腺功能亢进。 　　[关键词] 阿法骨化醇；碳酸镧；维持性腹膜透析；甲状旁腺功能亢进 　　[中图分类号] R459.5 [文献标识码] A [文章编号] 1674-4721（2014）08（b）-0096-03 　　[Abstract] Objective To observe the effect of lanthanum carbonate combined with alphacalcidol in the treatment of continuous peritoneal dialysis patients with secondary hyperparathyroidism. Methods 30 cases of continuous ambulatory peritoneal dialysis patients with secondary hyperparathyroidism were selected and randomly divided into control group（n=15，alphacalcidol 0.5 μg/d）and treatment group（n=15，alphacalcidol 0.5 μg/d+lanthanum carbonate 500 mg，three times a day）.In 3 months of treatment，serum calcium（Ca2+），serum phosphate（P3+）and serum intact parathyroid hormone（iPTH）was observed respectively. Results After 2 and 3 months of treatment in control group，only the level of serum Ca2+ increased obviously between before and after treatment，with statistical difference（P0.05）in control group.In treatment group，serum P3+ began to fall evidently after 1 month of combination therapy with lanthanum carbonate（P0.05）.Serum Ca2+ and iPTH showed significant change after 2 month of treatment（P0.05）.There was statistical difference on the serum P3+ and iPTH between treatment group and control group after 3 months respectively（P0.05）. Conclusion Alphacalcidol combined lanthanum carbonate can obviously improve the calcium and phosphorus metabolism disorder in peritoneal dialysis patients，and relieve secondary hyperparathyroidism effectively. 　　[Key words] Alphacalcidol；Lanthanum carbonate；Continous peritoneal dialysis；Hyperparathyroidism 　　慢性肾脏疾病（chronic ki