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目的:观察司维拉姆联合西那卡塞对维持性血液透析并发继发性甲状旁腺功能亢进患者的疗效及对成纤维细胞生长因子23(FGF-23)和钙、磷的影响。方法:选取2017年4月至2018年10月在本院收治的并发继发性甲状旁腺功能亢进[甲状旁腺激素(iPTH)>300 pg/mL]的维持性血液透析患者110例，随机将患者分为碳酸司维拉姆治疗组(对照组)和碳酸司维拉姆联合西那卡塞治疗组(观察组)，各55例，治疗16个月，观察并比较两组的血钙、血磷、超敏C反应蛋白(hs-CRP)、血iPTH、FGF-23及左心室厚度(LVd)等指标。结果:治疗16个月后，两组患者的血钙、血磷、hs-CRP、血iPTH及FGF-23均低于治疗前，且观察组比对照组下降更明显，两组比较差异具有统计学意义(n P0.05)。n 结论:司维拉姆联合西那卡塞对iPTH和钙磷代谢均有着较好的控制，能有效降低血液透析患者的FGF-23水平，可能对减少心血管事件和肾性骨病有益。“,”Objective:To observe the effect of sevelamer combined with cinacalce on fibroblast growth factor 23(FGF-23) and calcium and phosphorus in patients with maintenance hemodialysis.Methods:From April 2017 to October 2018, 110 patients with maintenance hemodialysis complicated with secondary hyperparathyroidism(iPTH>300 pg/mL) in our hospital were selected.The patients were randomly divided into sevelamer carbonate group(control group) and sevelamer carbonate+ sevelamer group(treatment group) with 55 cases each for 16 months, and the clinical indicators of the two groups were observed and analyzed.Results:Sixteen months after treatment, the treatment group and control group in the blood of the blood calcium, phosphorus and the calcium-phosphorus product were lower than before the treatment, the treatment group was lower than the control group, there was statistically significant difference(n P<0.05), the treatment group and control group in blood iPTH, FGF-23 were lower than before treatment, and the treatment group decreased more significantly(n P0.05).n Conclusions:Both iPTH and calcium and phosphorus metabolism are well controlled by sevelamer combined with cinacalce, effectively reducing FGF-23 in hemodialysis patients, which may be beneficial to reduce cardiovascular events and renal bone diseases.