论文部分内容阅读
目的观察骨化三醇对尿毒症维持性血透(MHD)患者继发性甲状旁腺功能亢进症(SHPT)的远期疗效。方法血透的26例尿毒症合并SHPT患者随机分成冲击治疗组和常规治疗组,各13例。常规治疗组给予骨化三醇0.25~0.50μg治疗;冲击治疗组根据i PTH水平给予不同剂量的骨化三醇治疗。观察两组患者治疗前、后甲状旁腺激素、血钙、血磷及钙磷乘积和患者临床症状的变化。结果两组总有效率无明显差别(P>0.05);治疗后两组患者i PTH均明显下降(P<0.05);常规治疗组Ca、P及Ca×P水平与治疗前比较无明显差别(P>0.05);冲击治疗组Ca、Ca×P水平与治疗前比较升高(P<0.05),血P水平无明显变化(P>0.05);冲击治疗组患者i PTH、P与常规治疗组比较无明显差别(P>0.05),而血Ca、Ca×P水平比常规治疗组明显升高(P<0.05)。结论维持性血透伴继发性甲状旁腺功能亢进症的尿毒症患者应用骨化三醇治疗,无论应用常规剂量持续给药或是冲击治疗方案,36个月后少数患者无效,大部分患者效果明显,两种治疗方法长期疗效无明显区别,但冲击治疗组患者血钙及钙磷乘积高于常规剂量治疗组。
Objective To observe the long-term effect of calcitriol on secondary hyperparathyroidism (SHPT) in patients with uremic-sustained hemodialysis (MHD). Methods Twenty-six cases of hemodialysis with SHPT were randomly divided into shock treatment group and conventional treatment group, with 13 cases in each group. Conventional treatment group given calcitriol 0.25 ~ 0.50μg treatment; impact treatment group according to i PTH level given different doses of calcitriol treatment. The changes of parathyroid hormone, serum calcium, phosphorus and calcium-phosphorus product before and after treatment were observed in two groups of patients. Results There was no significant difference in total effective rate between the two groups (P> 0.05). After treatment, the i PTH in both groups was significantly decreased (P <0.05). There was no significant difference in the levels of Ca, P and Ca × P between the two groups (P> 0.05). The levels of Ca and Ca × P in shock treatment group were significantly higher than those before treatment (P <0.05), but there was no significant change in blood P level (P> 0.05) (P> 0.05), but the levels of Ca, Ca and P in serum were significantly higher than those in the conventional treatment group (P <0.05). Conclusions Uremic patients with maintenance hemodialysis and secondary hyperparathyroidism are treated with calcitriol. However, few patients are ineffective after 36 months, regardless of whether they are given conventional treatment or shock treatment. Most patients The effect is obvious, long-term efficacy of the two treatment methods no significant difference, but the impact of treatment group patients calcium and calcium than the conventional dose treatment group.