不同方法治疗终末期肾脏病继发性甲旁亢疗效评价研究.docVIP

不同方法治疗终末期肾脏病继发性甲旁亢疗效评价研究【摘要】目的 观察评价骨化三醇冲击和常规每日治疗终末期肾脏病继发性甲状旁腺功能亢进(SHPT) 患者的疗效及安全性。方法 将28例终末期肾脏病维持性血液透析继发性SHPT 患者（甲状旁腺素iPTH500～1000pg/ml）随机分为冲击治疗组和常规治疗对照组，每组14 例。冲击治疗组给予骨化三醇胶丸2～4ug/次，每周2次；常规治疗对照组给予骨化三醇胶丸0.25ug/d维持治疗。所有患者均在透析后给予骨化三醇胶丸治疗，疗程12周，观察两组治疗前后症状改善情况及iPTH、Ca2+、P3-、AKP的变化情况和骨化三醇的不良反应。结果 冲击治疗组皮肤瘙痒、骨痛、皮乏无力等症状明显好转，血iPTH、P3-、AKP明显下降，血Ca2+升高，但无高钙血症及严重的不良反应，差异显著，有统计学意义（P0.05)。结论 骨化三醇冲击治疗终末期肾脏病维持性血液透析继发性SHPT疗效明显优于常规对照组的维持治疗，安全性良好。 【关键词】骨化三醇终末期肾脏病血液透析继发性甲旁亢甲状旁腺素 中图分类号：R692.5R582.11文献标识码：A文章编号：1005-0515（2011）2-017-02 Evaluation of Efficacy of Different Treatments for Secondary Hyperparathyroidism of End-stage Renal Diseases ZHANG zhuo1 YAN huazi2 （1. Loudi Central Hospital Department of Nephrology, Loudi 417000; 2. Loudi Central Hospital blood purification room, Loudi 417000） 【Abstract】Objective It is to observe and evaluate the efficacy and safety of calcitriol pulse therapy (CPT) and daily therapy for patients with secondary hyperparathyroidism (SHPT) of end-stage renal disease (ESRD). Methods Patients（iPTH500～1000pg/ml）with secondary hyperparathyroidism (SHPT) of end-stage renal disease (ESRD) on maintenance hemodialysis (MHD) were randomly divided into two groups: calcitriol pulse therapy group and daily therapy group (control group), with 14 patients in each group. Patient in calcitriol pulse therapy group was treated with 2～4ug calcitriol soft capsules each time and twice a week, while patient in the daily therapy group was treated with 0.25ug calcitriol soft capsules every day. All patients were treated with calcitriol soft capsules for 12 weeks after receiving hemodialysis. Improvements in symptoms, changes in levels of iPTH、Ca2+、P3-、AKP and untoward reactions of both groups were observed. Results Patients in calcitriol pulse therapy group had obvious improvements in skin pruritus, bone pains and fatigue. The level of iPTH，P3- and AKP decreased apparently and level of Ca2+ increased. But there were no hypercalcemia and serious untoward reactions