骨化三醇联合碳酸司维拉姆治疗终末期肾脏病合并甲状旁腺功能亢进症患者的效果及对hs-CRP、FGF-23水平的影响
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摘要
目的:探讨骨化三醇联合碳酸司维拉姆治疗终末期肾脏病合并甲状旁腺功能亢进症(SHPT)患者的效果及对患者超敏C反应蛋白(hs-CRP)、成纤维细胞生长因子-23(FGF-23)水平的影响。方法:选取2016年2月-2018年1月本院收治的终末期肾脏病合并SHPT患者80例。按照随机数字表法将其分为观察组和对照组,各40例。对照组在基础治疗上联合碳酸钙D治疗,观察组在对照组基础上联合盐酸司维拉姆治疗。比较两组治疗前后甲状旁腺激素(iPTH)、血磷、hs-CRP和FGF-23水平。结果:治疗后,观察组iPTH、血磷水平均低于对照组,比较差异均有统计学意义(P<0.05);治疗后,观察组hs-CRP和FGF-23水平均低于对照组,比较差异均有统计学意义(P<0.05)。结论:骨化三醇联合碳酸司维拉姆治疗终末期肾脏病合并SHPT患者效果显著,可有效减轻肾脏炎性反应,调节甲状旁腺功能,值得推广。
Objective:To investigate the effect of Rocalirol combined with Sevelamer Carbonate on patients with end-stage renal disease complicated with hyperparathyroidism(SHPT) and the effect on levels of hypersensitive C reactive protein(hs-CRP) and fibroblast growth factor-23(FGF-23).Method:80 patients with end-stage renal disease complicated with SHPT in our hospital from February 2016 to January 2018 were selected.According to the random number table method,they were divided into observation group and control group,40 cases in each group.The control group was treated with Calcium Carbonate D on the basic treatment,while observation group was treated with Sevelamer Carbonate on the basis of control group.The levels of parathyroid hormone(iPTH),blood phosphorus,hs-CRP and FGF-23 before and after treatment between two groups were compared.Result:After treatment,the levels of iPTH and blood phosphorus in observation group were lower than those of control group,the differences were statistically significant(P<0.05).After treatment,the levels of hsCRP and FGF-23 in observation group were lower than those of control group,the differences were statistically significant(P<0.05).Conclusion:Rocalirol combined with Sevelamer Carbonate on patients with end-stage renal disease complicated with SHPT has a significant effect,which can effectively alleviate the inflammatory reaction of the kidney and regulate the function of parathyroid gland,it is worth promoting.
Objective:To investigate the effect of Rocalirol combined with Sevelamer Carbonate on patients with end-stage renal disease complicated with hyperparathyroidism(SHPT) and the effect on levels of hypersensitive C reactive protein(hs-CRP) and fibroblast growth factor-23(FGF-23).Method:80 patients with end-stage renal disease complicated with SHPT in our hospital from February 2016 to January 2018 were selected.According to the random number table method,they were divided into observation group and control group,40 cases in each group.The control group was treated with Calcium Carbonate D on the basic treatment,while observation group was treated with Sevelamer Carbonate on the basis of control group.The levels of parathyroid hormone(iPTH),blood phosphorus,hs-CRP and FGF-23 before and after treatment between two groups were compared.Result:After treatment,the levels of iPTH and blood phosphorus in observation group were lower than those of control group,the differences were statistically significant(P<0.05).After treatment,the levels of hsCRP and FGF-23 in observation group were lower than those of control group,the differences were statistically significant(P<0.05).Conclusion:Rocalirol combined with Sevelamer Carbonate on patients with end-stage renal disease complicated with SHPT has a significant effect,which can effectively alleviate the inflammatory reaction of the kidney and regulate the function of parathyroid gland,it is worth promoting.
引文
[1]于泽莺,金鑫.血液灌流联合血液透析对糖尿病肾病血液透析患者预后的影响[J].吉林医学,2016,37(11):2697-2699.
[2]谭鹤长,宋雪霞,刘春晓.碳酸司维拉姆治疗维持性血液透析患者高磷血症疗效观察[J].新疆医科大学学报,2013,36(7):974-975,978.
[3]刘炎,秦岭,彭艾.司维拉姆对慢性肾脏病血管钙化及病死率的影响[J].同济大学学报(医学版),2016,37(3):138-143.
[4]郑慧,刘智楠.碳酸司维拉姆在慢性肾功能不全合并高磷血症患者治疗中的应用[J].山东医药,2016,56(14):70-71.
[5]王莉,李贵森,刘志红.中华医学会肾脏病学分会《慢性肾脏病矿物质和骨异常诊治指导》[J].肾脏病与透析肾移植杂志,2013,22(6):554-559.
[6]赵子秀,王淑华,柴涛.不同血流量血液灌流联合血液透析对尿毒症毒素清除效果的研究[J].中国中西医结合肾病杂志,2015,16(4):344-346.
[7]唐俊,左满花.血液透析联合血液灌流对尿毒症患者透析效率、脂代谢及动脉粥样硬化的影响[J].海南医学院学报,2017,23(4):497-500.
[8]刘智楠,郑慧,郭向辉.碳酸司维拉姆联合常规治疗对慢性肾衰竭合并高磷血症患者血清炎症因子及HO-1、iPTH水平的影响[J].中国药房,2018,29(5):683-686.
[9]王洪涛,黄远丽.骨化三醇胶丸联合替米沙坦片治疗早期糖尿病肾病的临床疗效[J].安徽医药,2016,20(4):790-792.
[10]曾海鸥,陈圳炜,罗敏虹,等.透析方式对非糖尿病终末期肾脏病患者临床指标及胰岛素抵抗影响的比较[J].中国血液净化,2016,15(4):219-225.
[11]刘向东,艾子敏.中西医结合治疗慢性肾功能衰竭对免疫功能、微炎症状态影响[J].中国中医基础医学杂志,2014,20(7):939-940,984.
[12]Hsieh Y P,Chang C C,Kor C T,et al.Relationship between uric acid and technique failure in patients on continuous ambulatory perito-neal dialysis:a longterm observational cohort study[J].BMJ Open,2017,7(4):e010816.
[13]赵袆,程海,李绍莉,等.碳酸司维拉姆对终末期肾脏病患者血清C反应蛋白、胎球蛋白A和成纤维细胞生长因子23水平的影响[J].中国中西医结合肾病杂志,2014,15(9):808-811.
[14]施凌云,季黎明,何华平,等.终末期肾脏病患者行维持性血液透析的营养状况及影响因素分析[J].现代生物医学进展,2016,16(3):478-480.
[15]Chiang J Y,Huang J W,Lin L Y,et al.Detrended Fluctuation Analysis of Heart Rate Dynamics Is an Important Prognostic Factor in Patients with End-Stage Renal Disease Receiving Peritoneal Dialysis[J].PLoS One,2016,11(2):e0147282.
[16]郭姗姗,王玉柱.碳酸司维拉姆治疗慢性肾脏病矿物质、骨代谢异常的研究进展[J].世界临床药物,2018,39(3):20-24.
[17]刘永贵,于鹏,吴疆,等.新型磷结合剂的研究进展[J].现代药物与临床,2014,29(2):201-205.
[18]姜玲,孔慧,张洁,等.中青年终末期肾脏病维持性血液透析患者认知功能改变及相关影响因素分析[J/OL].中国医学前沿杂志(电子版),2017,9(2):150-153.
[19]赵袆,王敬东,赵东明,等.碳酸司维拉姆治疗终末期肾脏病患者高磷血症疗效的随机对照研究[J].中国循证医学杂志,2014,14(11):1293-1298.
[20]赵劲,陈晓玲,张俊峰,等.盐酸司维拉姆对骨化三醇冲击治疗尿毒症继发性甲状旁腺功能亢者血磷的影响[J].海南医学,2012,23(18)37-38.
[2]谭鹤长,宋雪霞,刘春晓.碳酸司维拉姆治疗维持性血液透析患者高磷血症疗效观察[J].新疆医科大学学报,2013,36(7):974-975,978.
[3]刘炎,秦岭,彭艾.司维拉姆对慢性肾脏病血管钙化及病死率的影响[J].同济大学学报(医学版),2016,37(3):138-143.
[4]郑慧,刘智楠.碳酸司维拉姆在慢性肾功能不全合并高磷血症患者治疗中的应用[J].山东医药,2016,56(14):70-71.
[5]王莉,李贵森,刘志红.中华医学会肾脏病学分会《慢性肾脏病矿物质和骨异常诊治指导》[J].肾脏病与透析肾移植杂志,2013,22(6):554-559.
[6]赵子秀,王淑华,柴涛.不同血流量血液灌流联合血液透析对尿毒症毒素清除效果的研究[J].中国中西医结合肾病杂志,2015,16(4):344-346.
[7]唐俊,左满花.血液透析联合血液灌流对尿毒症患者透析效率、脂代谢及动脉粥样硬化的影响[J].海南医学院学报,2017,23(4):497-500.
[8]刘智楠,郑慧,郭向辉.碳酸司维拉姆联合常规治疗对慢性肾衰竭合并高磷血症患者血清炎症因子及HO-1、iPTH水平的影响[J].中国药房,2018,29(5):683-686.
[9]王洪涛,黄远丽.骨化三醇胶丸联合替米沙坦片治疗早期糖尿病肾病的临床疗效[J].安徽医药,2016,20(4):790-792.
[10]曾海鸥,陈圳炜,罗敏虹,等.透析方式对非糖尿病终末期肾脏病患者临床指标及胰岛素抵抗影响的比较[J].中国血液净化,2016,15(4):219-225.
[11]刘向东,艾子敏.中西医结合治疗慢性肾功能衰竭对免疫功能、微炎症状态影响[J].中国中医基础医学杂志,2014,20(7):939-940,984.
[12]Hsieh Y P,Chang C C,Kor C T,et al.Relationship between uric acid and technique failure in patients on continuous ambulatory perito-neal dialysis:a longterm observational cohort study[J].BMJ Open,2017,7(4):e010816.
[13]赵袆,程海,李绍莉,等.碳酸司维拉姆对终末期肾脏病患者血清C反应蛋白、胎球蛋白A和成纤维细胞生长因子23水平的影响[J].中国中西医结合肾病杂志,2014,15(9):808-811.
[14]施凌云,季黎明,何华平,等.终末期肾脏病患者行维持性血液透析的营养状况及影响因素分析[J].现代生物医学进展,2016,16(3):478-480.
[15]Chiang J Y,Huang J W,Lin L Y,et al.Detrended Fluctuation Analysis of Heart Rate Dynamics Is an Important Prognostic Factor in Patients with End-Stage Renal Disease Receiving Peritoneal Dialysis[J].PLoS One,2016,11(2):e0147282.
[16]郭姗姗,王玉柱.碳酸司维拉姆治疗慢性肾脏病矿物质、骨代谢异常的研究进展[J].世界临床药物,2018,39(3):20-24.
[17]刘永贵,于鹏,吴疆,等.新型磷结合剂的研究进展[J].现代药物与临床,2014,29(2):201-205.
[18]姜玲,孔慧,张洁,等.中青年终末期肾脏病维持性血液透析患者认知功能改变及相关影响因素分析[J/OL].中国医学前沿杂志(电子版),2017,9(2):150-153.
[19]赵袆,王敬东,赵东明,等.碳酸司维拉姆治疗终末期肾脏病患者高磷血症疗效的随机对照研究[J].中国循证医学杂志,2014,14(11):1293-1298.
[20]赵劲,陈晓玲,张俊峰,等.盐酸司维拉姆对骨化三醇冲击治疗尿毒症继发性甲状旁腺功能亢者血磷的影响[J].海南医学,2012,23(18)37-38.