摘要
目的分析活性维生素D联合西那卡塞治疗透析后继发甲状旁腺功能亢进的临床效果。方法目的选取南京鼓楼医院集团安庆石化医院于2022年2月—2023年8月收治的83例血液透析后继发性甲状旁腺功能亢进患者为研究对象,根据具体治疗方式分成观察组(n=41)和对照组(n=42)。对照组采用活性维生素D治疗,观察组采用活性维生素D联合西那卡塞治疗。对比两组患者的血钙、血磷、尿素氮(bloodurea nitrogen,BUN)、血肌酐(serum creatinine,Scr)、甲状旁腺激素(parathyroid hormone,PTH)水平及临床治疗效果、不良反应发生率。结果治疗后,观察组与对照组的血钙、血磷以及BUN与Scr浓度均有改善,其中,观察组在血钙和血磷方面的改善优于对照组,差异有统计学意义(P均<0.05),而两组BUN与Scr的清除率比较,差异无统计学意义(P均>0.05),且两组PTH均有下调,观察组明显低于对照组,差异有统计学意义(P<0.05);观察组治疗有效率为95.12%(39/41)明显高于对照组的78.57%(33/42),差异有统计学意义(χ^(2)=4.943,P<0.05);观察组患者治疗后的不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。结论采用活性维生素D联合西那卡塞的治疗方法可有效降低血钙、血磷和PTH含量,治疗效果较好,且安全性较高。
Objective To analyze the clinical effect of active vitamin D combined with cinacalcet in the treatment of secondary hyperthyroidism after dialysis.Methods Purposely selected eighty-three cases of patients with secondary hyperthyroidism after hemodialysis admitted to Anqing Petrochemical Hospital of Nanjing Drum Tower Hospital Group from February 2022 to August 2023 as the study subjects.According to the specific treatment methods,they were di⁃vided into observation group(n=41)and control group(n=42).The control group was treated with active vitamin D,and the observation group was treated with active vitamin D combined with cinacalcet.The levels of blood calcium,blood phosphorus,blood urea nitrogen(BUN),serum creatinine(Scr),parathyroid hormone(PTH),clinical treatment effect and incidence of adverse reactions were compared between the two groups.Results After treatment,the blood calcium,blood phosphorus,BUN and Scr concentrations in the observation group and the control group were improved,The differences were statistically significant(all P<0.05).Among them,the improvement of blood calcium and blood phosphorus in the observation group was significantly better than that in the control group,and the differences were statistically significant(both P<0.05).PTH was down-regulated in both groups,and the observation group was lower than the control group,and the difference was statistically significant(P<0.05).The effective rate of treatment in the observation group was 95.12%(39/41),which was significantly higher than 78.57%(33/42)in the control group,and the difference was statistically significant(χ^(2)=4.943,P<0.05).The incidence of adverse reactions after treatment in the observation group was significantly lower than that in the control group,and the difference was statistically signifi⁃cant(P<0.05).Conclusion The treatment method of active vitamin D combined with cinacalcet can effectively reduce the contents of serum calcium,phosphorus and PTH.The treatment effect is effective and the safety is high.
作者
叶葳
何晓旋
江斌
YE Wei;HE Xiaoxuan;JIANG Bin(Department of Nephrology,Anqing Petrochemical Hospital,Nanjing Drum Tower Hospital Group,Anqing 246001,An-hui,China)
出处
《系统医学》
2024年第17期103-106,111,共5页
Systems Medicine
