西那卡塞治疗血透患者继发性甲状旁腺功能亢进的观察.docVIP

西那卡塞治疗血透患者继发性甲状旁腺功能亢进的观察 　　【摘要】 目的：观察西那卡塞治疗血透患者继发性甲状旁腺功能亢进的疗效与安全性。方法：30例血透合并继发性甲状旁腺功能亢进的患者随机分为对照组与观察组，对照组予骨化三醇治疗，观察组同时加用西那卡塞，观察比较两组治疗效果。结果：治疗后，两组患者的血清磷、iPTH较治疗前均显著下降。对照组的血钙较治疗前显著升高，观察组患者的血清磷、iPTH下降幅度显著高于对照组，差异均有统计学意义（P0.05）。结论：血透患者合并继发性甲状旁腺功能亢进，联用骨化三醇与西那卡塞治疗，效果确切，安全性良好。 　　【关键词】 血液透析； 西那卡塞； 继发性甲状旁腺功能亢进 　　中图分类号 R692.5 文献标识码 A 文章编号 1674-6805（2016）27-0004-02 　　Observation of Cinacalcet in the Treatment of Hemodialysis Patients with Secondary Hyperparathyroidism/ZHANG Heng-yuan，ZHOU Ling-hui，ZHANG Yan-lin.//Chinese and Foreign Medical Research，2016，14（27）：4-5 　　【Abstract】 Objective：To study the effect and safety of Cinacalcet in hemodialysis patients with secondary hyperparathyroidism（SHPT）.Method：30 hemodialysis patients with SHPT were randomly divided into observation group and control group.Each group was given Calcitriol，besids，the observation group was extra given Cinacalcet.The effect of the two groups were observed.Result：After treatment，in each group，the level of phosphor and iPTH significantly declined.In control group，the calcium level increased.The levels of phosphor and iPTH in the observation group were lower than those in the control group，the differences were statistically significant（P0.05）.Conclusion：For hemodialysis patients with SHPT，Cinacalcet combined with Calcitriol can increase effective rate and has high safety. 　　【Key words】 Hemodialysis； Cinacalcet； Secondary hyperparathyroidism 　　First-author’s address：The First Affiliated Hospital of Xiamen University，Xiamen 361003，China 　　doi：10.14033/j.cnki.cfmr.2016.27.002 　　慢性肾脏病-矿物质与骨异常（chronic kidney disease-mineral and bone disorder，CKD-MBD）是长期透析患者常见的并发症，其中继发性甲状旁腺功能亢进（secondary hyperparathyroidism，SHPT）的危害尤其突出，其增加骨病、心血管疾病的发生率，更增加致残率、致死率。治疗SHPT的传统药物有钙剂、活性维生素D及其衍生物。而盐酸西那卡塞是一种新型的拟钙剂，对SHPT的治疗作用不依赖于血钙水平的升高，相反却可能引起低血钙[1]。考虑到骨化三醇是治疗SHPT的经典药物，且有升高血钙的作用[2]。笔者选取了血透合并SHPT的患者，在应用骨化三醇的基础上，联合西那卡塞治疗，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　选择2014年9月-2016年3月笔者所在医院血透室的30例患者。入选标准是：终末期肾脏病（end stage renal disease，ESRD