CAJ | 학술논문

目的：观察碳酸镧联合阿法骨化醇治疗维持性腹膜透析患者继发甲状旁腺功能亢进的效果。方法选取30例维持性非卧床腹膜透析继发甲状旁腺功能亢进患者,随机分为对照组(n=15,阿法骨化醇0.5μg/d)和治疗组(n=15,阿法骨化醇0.5μg、1次/d+碳酸镧500 mg、3次/d),观察治疗前及治疗后连续3个月的血Ca2+、血P3+及血全段甲状旁腺激素(iPTH)水平变化。结果对照组治疗2、3个月后,仅血Ca2+有明显改善(P<0.05),血P3+、血iPTH与治疗前比较差异无统计学意义(P>0.05)。治疗组的血P3+于治疗后1个月开始下降,血Ca2+、血iPTH于治疗后2个月开始有显著改善(P<0.05)；与对照组治疗3个月相比,治疗组血P3+、血iPTH改善明显,差异有统计学意义(P<0.05)。结论在阿法骨化醇基础上加用碳酸镧可明显改善维持性腹膜透析患者钙磷代谢紊乱,有效缓解继发甲状旁腺功能亢进。
목적：관찰탄산란연합아법골화순치료유지성복막투석환자계발갑상방선공능항진적효과。방법선취30례유지성비와상복막투석계발갑상방선공능항진환자,수궤분위대조조(n=15,아법골화순0.5μg/d)화치료조(n=15,아법골화순0.5μg、1차/d+탄산란500 mg、3차/d),관찰치료전급치료후련속3개월적혈Ca2+、혈P3+급혈전단갑상방선격소(iPTH)수평변화。결과대조조치료2、3개월후,부혈Ca2+유명현개선(P<0.05),혈P3+、혈iPTH여치료전비교차이무통계학의의(P>0.05)。치료조적혈P3+우치료후1개월개시하강,혈Ca2+、혈iPTH우치료후2개월개시유현저개선(P<0.05)；여대조조치료3개월상비,치료조혈P3+、혈iPTH개선명현,차이유통계학의의(P<0.05)。결론재아법골화순기출상가용탄산란가명현개선유지성복막투석환자개린대사문란,유효완해계발갑상방선공능항진。
Objective To observe the effect of lanthanum carbonate combined with alphacalcidol in the treatment of continuous peritoneal dialysis patients with secondary hyperparathyroidism. Methods 30 cases of continuous ambulatory peritoneal dialysis patients with secondary hyperparathyroidism were selected and randomly divided into control group (n=15,alphacalcidol 0.5 μg/d)and treatment group (n=15,alphacalcidol 0.5 μg/d+lanthanum carbonate 500 mg,three times a day).In 3 months of treatment,serum calcium (Ca2+),serum phosphate (P3+)and serum intact parathyroid hormone (iPTH)was observed respectively. Results After 2 and 3 months of treatment in control group,only the level of serum Ca2+increased obviously between before and after treatment,with statistical difference (P<0.05).There was no statistical difference in the change of serum P3+and iPTH (P>0.05)in control group.In treatment group,serum P3+began to fall evi-dently after 1 month of combination therapy with lanthanum carbonate(P<0.05).Serum Ca2+and iPTH showed significant change after 2 month of treatment(P<0.05).There was statistical difference on the serum P3+and iPTH between treatment group and control group after 3 months respectively(P<0.05). Conclusion Alphacalcidol combined lanthanum carbonate can obviously improve the calcium and phosphorus metabolism disorder in peritoneal dialysis patients,and relieve sec-ondary hyperparathyroidism effectively.