CAJ | 학술논문

目的探讨小剂量维生素D受体激活剂(骨化三醇)对血液透析患者血钙、血磷和成纤维细胞生长因子23的影响.方法 20例血液透析患者应用骨化三醇(每天0.25μg)治疗,分别于用药前、用药4、8周观察患者血钙、血磷、碱性磷酸酶、全段甲状旁腺激素和成纤维细胞因子23水平.结果用药4周和8周后患者血钙明显上升(但尚未超过正常范围),与治疗前比较差异有统计学意义(P＜0.01)；用药4周和8周后血磷有所下降,但与治疗前比较差异无统计学意义(P＞0.05)；用药4周和8周后血碱性磷酸酶明显下降,与治疗前比较差异有统计学意义(P＜0.01)；用药4周后血全段甲状旁腺激素有所下降,但与治疗前比较差异无统计学意义(P＞0.05)；用药4周和8周后血成纤维细胞因子23明显升高,与治疗前比较差异有统计学意义(P＜0.01).结论小剂量维生素D受体激活剂(骨化三醇)对维持性血液透析患者具有升高血钙、抑制碱性磷酸酶并升高成纤维细胞生长因子23的作用.
목적 탐토소제량유생소D수체격활제(골화삼순)대혈액투석환자혈개、혈린화성섬유세포생장인자23적영향.방법 20례혈액투석환자응용골화삼순(매천0.25μg)치료,분별우용약전、용약4、8주관찰환자혈개、혈린、감성린산매、전단갑상방선격소화성섬유세포인자23수평.결과 용약4주화8주후환자혈개명현상승(단상미초과정상범위),여치료전비교차이유통계학의의(P＜0.01)；용약4주화8주후혈린유소하강,단여치료전비교차이무통계학의의(P＞0.05)；용약4주화8주후혈감성린산매명현하강,여치료전비교차이유통계학의의(P＜0.01)；용약4주후혈전단갑상방선격소유소하강,단여치료전비교차이무통계학의의(P＞0.05)；용약4주화8주후혈성섬유세포인자23명현승고,여치료전비교차이유통계학의의(P＜0.01).결론 소제량유생소D수체격활제(골화삼순)대유지성혈액투석환자구유승고혈개、억제감성린산매병승고성섬유세포생장인자23적작용.
Objective To investigate the effect so low-dose vitamin D receptor activator(calcitriol) on serum calcium,phosphorus and fibroblast growth factor 23 in hemodialysis petients.Methods 20 patients with end stage renal disease on regular hemodialysis had been treated with calcitriol (0.25/μg/d) for 8 weeks.The serum level of calcium ( Ca2 + ),phosphorus (P3-),alkaline phosphatase (AKP),intact parathyroid hormone (iPTH) and fibroblast growth factor 23 (FGF-23) were observed before and after 4 weeks (4W) and 8 weeks (8W).Results The sennn level of Ca2+ increased significantly after 4W and 8W,respectively ( P ＜ 0.01),but they were still in the normal range.The serum level of P3- decreased after 4W and 8W,respectively,but no statistical significance ( P ＞ 0.05).AKP decreased significantly after 4W and 8W,respectively ( P ＜0.01).The serum level of iPTH decreased after 4W,but no statistical signiticance ( P ＞ 0.05).FGF-23 increased significantly after 4W and 8W,respectively ( P ＜ 0.01 ).Conclusion Low-dose vitamin D receptor activator (calcitriol) can increase the serum calcium,inhibit the alkaline phosphatase and increase the fibroblast growth factor 23 in hemodialysis patients.