摘要
目的对比碳酸镧与醋酸钙治疗维持性透析患者高磷血症的效果。方法我院收治的终末期慢性肾脏病(CKD)维持性血液透析高磷血症患者42例,按维持治疗期治疗方案不同将其分为观察组(碳酸镧咀嚼片)和对照组(醋酸钙片)各21例。比较两组治疗前、服药后1、2、4周及4、8、12个月血钙(Ca)、血磷(P)水平及钙磷乘积,于治疗4周及12月后测定甲状旁腺激素(iPTH)水平,应用健康调查简表(SF-36)、自我感受负担量表(SPBS)评价其生活质量及自我感受负担程度,并观察不良反应。结果两组血磷均在短期内下降;在治疗第4周、治疗4、8个月,观察组血磷、钙磷乘积下降幅度大于对照组,对照组血钙在治疗2周开始持续增加(P<0.05),观察组血钙较治疗前无明显变化(P>0.05);两组治疗后12个月iPTH均低于治疗前(P<0.05),组间比较差异无统计学意义(P>0.05)。观察组治疗后SPBS评分低于对照组,SF-36评分高于对照组(P<0.05);两组不良反应发生率比较差异无统计学意义(P=0.707)。结论碳酸镧应用于CKD维持性血液透析高磷血症患者中,可明显降低其血磷、钙磷乘积及PTH等水平,提高生活质量,降低患者自我感受负担,且对血钙影响小,值得在临床推广应用。
Objective To compare the effects of lanthanum carbonate and calcium acetate in the treatment of hyperphosphatemia in patients undergoing maintenance dialysis.Methods A total of 42 patients with end-stage renal disease（ ESRD） with hyperphosphatemia treated by maintenance hemodialysis in our hospital were selected.They were divided into the observation group（ n =21） treated with lanthanum carbonate chewable tablets and the control group（ n = 21） treated with calcium acetate tablets. Levels of blood calcium（ Ca） and serum phosphorus（ P） and calcium-phosphorus product were compared between the two groups before and at1,2,4 weeks and 4,8 and 12 months after treatment.Levels of serum intact parathyroid hormone（ iPTH） were determined at 4 weeks and 12 months after treatment.The quality of life and the degree of self-perceived burden were evaluated by short form health survey（ SF-36） and the self-perceived burden scale（ SPBS）.Adverse reactions were also observed.Results After treatment,serum phosphorus level was decreased in short-term,and the decreasing degree of serum phosphorus and calcium-phosphorus products at 4 weeks and 4 and 8 months in the observation group were significantly lower than those in the control group. The blood calcium level was increased significantly in the control group since 2 weeks after treatment（ P〈0. 05） but no significantly change was observed in the observation group when compared to before treatment（ P〉0. 05）.The iPTH at 12 months after treatment was higher than that before treatment（ P〈0. 05）,but there was no obvious difference between the two groups（ P〉0. 05）. After treatment,the SPBS score in the observation group was lower than that in the control group（ P〈0. 05） while the SF-36 score was higher than that in the control group（ P〈0. 05）.No significant difference in the incidence of adverse reactions was found between the two groups（ P = 0. 707）. Conclusion Lanthanum carbonate can significantly improve the levels of serum P,calcium-phosphorus product and iPTH,improve the quality of life,and reduce the self-perceived burden of patients.Therefore,it is worthy of recommendation for clinical application.
作者
蔡震川
李培贵
张万军
宋春燕
吉果
范元杰
周豪
周晓春
陈婷婷
曾文超
CAI Zhen-chuan;IJ Pei-gui;ZHANG Wang-jun;SONG Chun-yan;JI Guo;FAN Yuan-jie;ZHOU Hao;ZHOU Xiao-chun;CHEN Ting-ting;ZENG Wen- chao(Department of Nephrology , Guanghan Second People＇s Hospital , Guanghan 618300,China)
出处
《实用医院临床杂志》
2018年第3期175-178,共4页
Practical Journal of Clinical Medicine
关键词
碳酸镧
醋酸钙
维持性透析
高磷血症
血磷
血钙
Lanthanum carbonate
Calcium acetate
Maintenance hemodialysis
Hyperphosphatemia
Serum phosphorus
Serumcalcium.
