CAJ | 학술논문

目的：观察不同制剂密钙息联合骨化三醇对血液透析导致肾性骨病患者的治疗效果。方法：选择血液透析导致肾性骨病伴高甲状旁腺素（PTH）、高磷血症同时伴有临床症状的患者106例，按照前瞻随机和对照的研究方法分为治疗组与对照组，每组各53例，对所有患者除治疗基础疾病、透析（血液或腹膜透析）、补充钙剂外，治疗组给予密钙息鼻喷剂联合骨化三醇：密盖息鼻喷剂200 IU，前2周每天1次，后隔天1次。3个月为一疗程；对照组给予密钙息肌注联合骨化三醇：密盖息注射液50 IU，肌肉注射，前2周每天1次，第3、4周隔日1次，后每周2次。3个月后观察各组治疗前后肾性骨病症状及血磷、血钙、PTH改变。结果：治疗后，两组肾性骨病相关症状明显好转，血磷、血PTH明显下降，血钙升高；治疗组治疗前血清钙、血清磷和PTH分别为（2.04±0.27）、（2.78±0.31）、（858.50±119.98），治疗后分别为（2.36±0.19）、（2.18±0.21）、（719.79±120.14）；对照组治疗前血钙、血磷水平、PTH分别为（2.11±0.39）、（2.87±0.23）、（891.45±124.73），治疗后分别为（2.39±0.34）、（2.19±0.13）、（721.69±117.56）。两组上述指标治疗前后比较差异有统计学意义（P<0.05），但两组间比较差异无统计学意义（P>0.05）；两组骨痛症状均改善明显，但治疗组在缓解时间上优于对照组，差异有统计学意义（P<0.05）；且治疗组副作用较少。结论：密钙息对肾性骨病治疗鼻喷剂副作用少，更为简便、实用、耐受性好，并可以迅速缓解骨痛。
목적：관찰불동제제밀개식연합골화삼순대혈액투석도치신성골병환자적치료효과。방법：선택혈액투석도치신성골병반고갑상방선소（PTH）、고린혈증동시반유림상증상적환자106례，안조전첨수궤화대조적연구방법분위치료조여대조조，매조각53례，대소유환자제치료기출질병、투석（혈액혹복막투석）、보충개제외，치료조급여밀개식비분제연합골화삼순：밀개식비분제200 IU，전2주매천1차，후격천1차。3개월위일료정；대조조급여밀개식기주연합골화삼순：밀개식주사액50 IU，기육주사，전2주매천1차，제3、4주격일1차，후매주2차。3개월후관찰각조치료전후신성골병증상급혈린、혈개、PTH개변。결과：치료후，량조신성골병상관증상명현호전，혈린、혈PTH명현하강，혈개승고；치료조치료전혈청개、혈청린화PTH분별위（2.04±0.27）、（2.78±0.31）、（858.50±119.98），치료후분별위（2.36±0.19）、（2.18±0.21）、（719.79±120.14）；대조조치료전혈개、혈린수평、PTH분별위（2.11±0.39）、（2.87±0.23）、（891.45±124.73），치료후분별위（2.39±0.34）、（2.19±0.13）、（721.69±117.56）。량조상술지표치료전후비교차이유통계학의의（P<0.05），단량조간비교차이무통계학의의（P>0.05）；량조골통증상균개선명현，단치료조재완해시간상우우대조조，차이유통계학의의（P<0.05）；차치료조부작용교소。결론：밀개식대신성골병치료비분제부작용소，경위간편、실용、내수성호，병가이신속완해골통。
Objective: To observe the different preparations miacalcic combined with ossification in three alcohol for hemodialysis in patients with renal osteodystrophy treatment effect.Method:106 patients who got the renal bone disease with higher parathyroid hormone (PTH) and hyperphosphatemia caused by hemodialysis were selected, and at the same time, they presented with clinical symptoms, and were divided into the treatment group and the control group according to the research methods of prospectie randomized and controlled, 53 cases in each group, all the patients in the treatment of the underlying disease, dialysis (blood or peritoneal dialysis), complement calcium and Calcitriol; the treatment group was given Calcitonin nasal spray 200 IU, 1 times a day before 2 weeks, then 1 times on alternate days, 3 months for a course. The control group was given Miacalcic injection 50 IU, intramuscular injection, 1 times a day before 2 weeks, 1 times on alternate days in 3 and 4 weeks, then 2 times a week. After 3 months, the changes of renal osteopathy symptoms and serum phosphorus, serum calcium, PTH of two groups before and after treatment were observed.Result:After the treatment, symptoms of renal osteodystrophy was improved significantly, serum phosphorus, serum PTH decreased significantly, serum calcium level, the treatment group before treatment, serum calcium, phosphorus, parathyroid hormone (PTH) were (2.04±0.27), (2.78±0.31), (858.50±119.98), after treatment were (2.36±0.19), (2.18±0.21), (719.79±120.14); the control group before treatment were (2.11±0.39), (2.87±0.23), (891.45±124.73), after treatment were (2.39±0.34), (2.19±0.13), (721.69±117.56); serum calcium, serum phosphorus and PTH were changed significantly before and after treatment in both groups (P<0.05), but no significant differences were observed between the two groups (P>0.05); the pain symptoms of two groups were improved obviously, but in the relief time, the treatment group was better than that of the control group, the difference was statistically significant (P<0.05); and the treatment group was less side effects.Conclusion: Calcitonin on renal osteopathy treatment of nasal spray with little side effect, more convenient, practical, good tolerance, and can quickly relieve pain.