西那卡塞联合骨化三醇对腹膜透析患者难治性甲状旁腺功能亢进的疗效及对骨代谢的影响
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摘要
目的:观察与探究西那卡塞联合骨化三醇对腹膜透析患者难治性甲状旁腺功能亢进的疗效及其对骨代谢的影响。方法:选取2016年10月-2018年9月本院收治的76例腹膜透析患者难治性甲状旁腺功能亢进为研究对象,根据随机数字表法分为对照组(骨化三醇组)38例和观察组(西那卡塞联合骨化三醇组)38例。比较两组患者治疗后不同时间的临床总有效率,治疗前后全段甲状旁腺激素(iPTH)、血钙(Ca)、血磷(P)水平及达标率,治疗前后骨代谢指标。结果:观察组治疗后不同时间临床总有效率均高于对照组,治疗后iPTH、Ca、P水平均低于对照组,达标率均高于对照组,骨代谢指标均优于对照组,差异均有统计学意义(P<0.05)。结论:西那卡塞联合骨化三醇对腹膜透析患者难治性甲状旁腺功能亢进的疗效较好,且对骨代谢的影响更为积极,因此在腹膜透析患者难治性甲状旁腺功能亢进中的应用价值较高。
Objective:To observe and investigate the effect of Cinacalcet combined with Calcitriol in the treatment of patients with refractory hyperparathyroidism and peritoneal dialysis and its influence for the bone metabolism.Method:A total of 76 patients with refractory hyperparathyroidism and peritoneal dialysis from October2016 to September 2018 were chosen for the study,and they were divided into the control group(Calcitriol) 38 cases and the observation group(Cinacalcet combined with Calcitriol)38 cases by the method of random number table.Then the total effective rates at different time after the treatment,levels of iPTH,blood Ca and P,before and after the treatment and standard-reaching rates,bone metabolism indexes before and after the treatment of two groups were compared.Result:The total effective rates of observation group at different time after the treatment were all higher than those of the control group,the levels of iPTH,blood Ca and P after treatment were lower than those of the control group,the standard-reaching rates were higher than those of the control group,the bone metabolism indexes were better than those of the control group,the differences of two groups were all statistically significant(P<0.05).Conclusion:The effect of Cinacalcet combined with Calcitriol in the treatment of refractory hyperparathyroidism and peritoneal dialysis is better,and its influence for the bone metabolism are more active,so its application value in the patients with refractory hyperparathyroidism and peritoneal dialysis is higher.
Objective:To observe and investigate the effect of Cinacalcet combined with Calcitriol in the treatment of patients with refractory hyperparathyroidism and peritoneal dialysis and its influence for the bone metabolism.Method:A total of 76 patients with refractory hyperparathyroidism and peritoneal dialysis from October2016 to September 2018 were chosen for the study,and they were divided into the control group(Calcitriol) 38 cases and the observation group(Cinacalcet combined with Calcitriol)38 cases by the method of random number table.Then the total effective rates at different time after the treatment,levels of iPTH,blood Ca and P,before and after the treatment and standard-reaching rates,bone metabolism indexes before and after the treatment of two groups were compared.Result:The total effective rates of observation group at different time after the treatment were all higher than those of the control group,the levels of iPTH,blood Ca and P after treatment were lower than those of the control group,the standard-reaching rates were higher than those of the control group,the bone metabolism indexes were better than those of the control group,the differences of two groups were all statistically significant(P<0.05).Conclusion:The effect of Cinacalcet combined with Calcitriol in the treatment of refractory hyperparathyroidism and peritoneal dialysis is better,and its influence for the bone metabolism are more active,so its application value in the patients with refractory hyperparathyroidism and peritoneal dialysis is higher.
引文
[1]李兰,应旭旻.维持性血液透析伴继发性甲状旁腺功能亢进治疗进展[J].浙江中西医结合杂志,2018,28(4):338-340.
[2]吕缘,徐承云.西那卡塞治疗透析患者继发性甲状旁腺功能亢进症的Meta分析[J].临床肾脏病杂志,2018,18(8):460-465.
[3]张新,周焕,王晓慧,等.西那卡塞治疗血液透析患者继发性甲状旁腺功能亢进的临床观察[J].临床肾脏病杂志,2018,18(3):156-159.
[4]刘洪萍,廖莹,李彤,等.帕立骨化醇治疗血液透析继发性甲状旁腺功能亢进症效果[J].深圳中西医结合杂志,2018,28(6):14-15.
[5]夏雪影,罗诗宏.维持性血液透析患者继发性甲状旁腺功能亢进相关因素分析[J].慢性病学杂志,2018,20(4):397-399.
[6]吴丽英,刘映红.西那卡塞治疗血液透析患者继发性甲状旁腺功能亢进的临床研究[J].川北医学院学报,2018,33(1):29-32,43.
[7]卞志翔,陈佩华,顾慧益,等.盐酸西那卡塞对透析患者继发性甲状旁腺功能亢进的疗效观察[J].兰州大学学报:医学版,2018,44(5):72-75.
[8]Wolfgang Pronai,Alexander R.Rosenkranz,Andreas Bock,et al.Management of secondary hyperparathyroidism:practice patterns and outcomes of cinacalcet treatment with or without active vitamin D in Austria and Switzerland-the observational TRANSITStudy[J].Wien Klin Wochenschr,2017,129(9):317-328.
[9]Stuart M.Sprague,James B.Wetmore,Konstantin Gurevich,et al.Effect of Cinacalcet and Vitamin D Analogs on Fibroblast Growth Factor-23 during the Treatment of Secondary Hyperparathyroidism[J].Clin J Am Soc Nephrol,2015,10(6):1021-1030.
[10]Behets G J,Spasovski G,Sterling L R,et al.Bone histomorphometry before and after long-term treatment with cinacalcet in dialysis patients with secondary hyperparathyroidism[J].Kidney Int,2015,87(4):846-856.
[11]陈璐.骨化三醇治疗血液透析患者继发性甲状旁腺功能亢进效果观察[J].河南医学研究,2018,27(7):1228-1229.
[12]汪涛,彭瑾,何冬梅,等.西那卡塞联合小剂量骨化三醇治疗透析患者继发性甲状旁腺功能亢进疗效观察[J].陕西医学杂志,2018,47(12):1629-1633.
[13]王垚,于博,魏巍,等.西那卡塞联合小剂量骨化三醇治疗血液透析患者继发性甲状旁腺功能亢进的疗效观察[J].中国中西医结合肾病杂志,2018,19(5):435-437.
[14]费良玉,李浩,张宝文.西那卡塞联合骨化三醇对血液透析患者难治性继发性甲状旁腺功能亢进的干预研究[J].中国医师杂志,2018,20(4):584-586.
[15]侯琳.西那卡塞联合小剂量骨化三醇应用于透析患者继发性甲状旁腺功能亢进治疗中疗效分析[J].系统医学,2018,3(6):31-33.
[16]孙桂江,魏芳,于海波,等.西那卡塞联合骨化三醇治疗维持性血液透析合并继发性甲状旁腺功能亢进患者的疗效观察[J].中华全科医师杂志,2018,17(9):717-720.
[17]Josep M.Cruzado,Pablo Moreno,JoséV.Torregrosa,et al.ARandomized Study Comparing Parathyroidectomy with Cinacalcet for Treating Hypercalcemia in Kidney Allograft Recipients with Hyperparathyroidism[J].J Am Soc Nephrol,2016,27(8):2487-2494.
[18]Amit Sharma,Thomas S.Marshall,Samina S.Khan,et al.Cost Effectiveness of Paricalcitol Versus Cinacalcet with Low-Dose Vitamin D for Management of Secondary Hyperparathyroidism in Haemodialysis Patients in the USA[J].Clin Drug Investig,2014,34(2):107-115.
[19]周凌辉,张恒远,裴娟,等.长疗程西那卡塞治疗维持性血液透析患者难治性继发性甲状旁腺功能亢进症的临床观察[J].中国全科医学,2018,21(8):989-992.
[20]王涛.西那卡塞治疗血液透析患者继发性甲状旁腺功能亢进的效果[J].实用临床医药杂志,2017,21(9):181-182,184.
[21]王琦,艾常虹,商庆辉.西那卡塞治疗继发性甲状旁腺功能亢进症的研究进展[J].中国药房,2017,28(23):3310-3312.
[2]吕缘,徐承云.西那卡塞治疗透析患者继发性甲状旁腺功能亢进症的Meta分析[J].临床肾脏病杂志,2018,18(8):460-465.
[3]张新,周焕,王晓慧,等.西那卡塞治疗血液透析患者继发性甲状旁腺功能亢进的临床观察[J].临床肾脏病杂志,2018,18(3):156-159.
[4]刘洪萍,廖莹,李彤,等.帕立骨化醇治疗血液透析继发性甲状旁腺功能亢进症效果[J].深圳中西医结合杂志,2018,28(6):14-15.
[5]夏雪影,罗诗宏.维持性血液透析患者继发性甲状旁腺功能亢进相关因素分析[J].慢性病学杂志,2018,20(4):397-399.
[6]吴丽英,刘映红.西那卡塞治疗血液透析患者继发性甲状旁腺功能亢进的临床研究[J].川北医学院学报,2018,33(1):29-32,43.
[7]卞志翔,陈佩华,顾慧益,等.盐酸西那卡塞对透析患者继发性甲状旁腺功能亢进的疗效观察[J].兰州大学学报:医学版,2018,44(5):72-75.
[8]Wolfgang Pronai,Alexander R.Rosenkranz,Andreas Bock,et al.Management of secondary hyperparathyroidism:practice patterns and outcomes of cinacalcet treatment with or without active vitamin D in Austria and Switzerland-the observational TRANSITStudy[J].Wien Klin Wochenschr,2017,129(9):317-328.
[9]Stuart M.Sprague,James B.Wetmore,Konstantin Gurevich,et al.Effect of Cinacalcet and Vitamin D Analogs on Fibroblast Growth Factor-23 during the Treatment of Secondary Hyperparathyroidism[J].Clin J Am Soc Nephrol,2015,10(6):1021-1030.
[10]Behets G J,Spasovski G,Sterling L R,et al.Bone histomorphometry before and after long-term treatment with cinacalcet in dialysis patients with secondary hyperparathyroidism[J].Kidney Int,2015,87(4):846-856.
[11]陈璐.骨化三醇治疗血液透析患者继发性甲状旁腺功能亢进效果观察[J].河南医学研究,2018,27(7):1228-1229.
[12]汪涛,彭瑾,何冬梅,等.西那卡塞联合小剂量骨化三醇治疗透析患者继发性甲状旁腺功能亢进疗效观察[J].陕西医学杂志,2018,47(12):1629-1633.
[13]王垚,于博,魏巍,等.西那卡塞联合小剂量骨化三醇治疗血液透析患者继发性甲状旁腺功能亢进的疗效观察[J].中国中西医结合肾病杂志,2018,19(5):435-437.
[14]费良玉,李浩,张宝文.西那卡塞联合骨化三醇对血液透析患者难治性继发性甲状旁腺功能亢进的干预研究[J].中国医师杂志,2018,20(4):584-586.
[15]侯琳.西那卡塞联合小剂量骨化三醇应用于透析患者继发性甲状旁腺功能亢进治疗中疗效分析[J].系统医学,2018,3(6):31-33.
[16]孙桂江,魏芳,于海波,等.西那卡塞联合骨化三醇治疗维持性血液透析合并继发性甲状旁腺功能亢进患者的疗效观察[J].中华全科医师杂志,2018,17(9):717-720.
[17]Josep M.Cruzado,Pablo Moreno,JoséV.Torregrosa,et al.ARandomized Study Comparing Parathyroidectomy with Cinacalcet for Treating Hypercalcemia in Kidney Allograft Recipients with Hyperparathyroidism[J].J Am Soc Nephrol,2016,27(8):2487-2494.
[18]Amit Sharma,Thomas S.Marshall,Samina S.Khan,et al.Cost Effectiveness of Paricalcitol Versus Cinacalcet with Low-Dose Vitamin D for Management of Secondary Hyperparathyroidism in Haemodialysis Patients in the USA[J].Clin Drug Investig,2014,34(2):107-115.
[19]周凌辉,张恒远,裴娟,等.长疗程西那卡塞治疗维持性血液透析患者难治性继发性甲状旁腺功能亢进症的临床观察[J].中国全科医学,2018,21(8):989-992.
[20]王涛.西那卡塞治疗血液透析患者继发性甲状旁腺功能亢进的效果[J].实用临床医药杂志,2017,21(9):181-182,184.
[21]王琦,艾常虹,商庆辉.西那卡塞治疗继发性甲状旁腺功能亢进症的研究进展[J].中国药房,2017,28(23):3310-3312.