CAJ | 학술논문

目的：探讨不同剂量盖三淳联合血液透析滤过治疗高转运性肾性骨营养不良的有效性和安全性。方法选择35例肾性骨营养不良患者作为研究对象，随机分为实验组和对照组，实验组采用小剂量盖三淳（0．5μg）联合血液透析滤过治疗，对照组采用大剂量盖三淳（1．0μg）联合血液透析滤过治疗，治疗16周后比较2组患者治疗前后肾功能指标、全段甲状旁腺激素（iPT H）、肾源性碱性磷酸酶（BAP）、血清钙、血清磷水平和临床症状改善情况。结果2组患者症状评分在治疗后均明显降低，与治疗前比较差异有统计学意义（P＜0．05），但组间比较差异仍无统计学意义（P＞0．05）。经过治疗后2组患者 iPT H 、钙磷乘积、血清钙、血清磷水平均得到改善，其中实验组iPT H 高于对照组，而钙磷乘积和血清磷水平低于对照组，差异有统计学意义（P＜0．05）。2组患者 BAP 经过治疗后均明显下降，其中对照组下降更为显著，与实验组比较差异有统计学意义（P＜0．05）。治疗后2组患者肾功能指标均无明显改善，且组间比较差异均无统计学意义（P ＞0．05）。结论在联合血液透析滤过治疗高转运性肾性骨营养不良时，小剂量盖三淳可取得与大剂量盖三淳相同的疗效，且不良反应更少，安全性更佳。
목적：탐토불동제량개삼순연합혈액투석려과치료고전운성신성골영양불량적유효성화안전성。방법선택35례신성골영양불량환자작위연구대상，수궤분위실험조화대조조，실험조채용소제량개삼순（0．5μg）연합혈액투석려과치료，대조조채용대제량개삼순（1．0μg）연합혈액투석려과치료，치료16주후비교2조환자치료전후신공능지표、전단갑상방선격소（iPT H）、신원성감성린산매（BAP）、혈청개、혈청린수평화림상증상개선정황。결과2조환자증상평분재치료후균명현강저，여치료전비교차이유통계학의의（P＜0．05），단조간비교차이잉무통계학의의（P＞0．05）。경과치료후2조환자 iPT H 、개린승적、혈청개、혈청린수평균득도개선，기중실험조iPT H 고우대조조，이개린승적화혈청린수평저우대조조，차이유통계학의의（P＜0．05）。2조환자 BAP 경과치료후균명현하강，기중대조조하강경위현저，여실험조비교차이유통계학의의（P＜0．05）。치료후2조환자신공능지표균무명현개선，차조간비교차이균무통계학의의（P ＞0．05）。결론재연합혈액투석려과치료고전운성신성골영양불량시，소제량개삼순가취득여대제량개삼순상동적료효，차불량반응경소，안전성경가。
Objective To evaluate the effectiveness and safety of different doses of calcitriol combined with he‐modiafiltration in treating renal osteodystrophy .Methods 35 cases of renal osteodystrophy in our hospital were cho‐sen as the research subjects and divided into the control group and the experimental group .The control group were treated with high dose of calcitriol(1 .0 μg) combined with hemodiafiltration ,while the experimental group adopted low dose of calcitriol(0 .5 μg) combined with hemodiafiltration .The indices of renal function ,iPT H ,BAP ,serum lev‐els of calcium and phosphorus and the improvement situation of clinical symptoms after 16‐week treatment were com‐pared between the two groups .Results The symptom scores of two group after treatment were significantly de‐creased compared with before treatment ,the difference had statistical significance(P< 0 .05) ,but there was no statis‐tically significant difference between the two groups(P> 0 .05) .The iPT H ,product of calcium and phosphorus ,ser‐um levels of calcium and phosphorus in the two group were improved after treatment ,the iPT H level of the experi‐mental group was higher than that of the control group ,the product of calcium and phosphorus ,and serum phosphor‐us level were lower than those in the control group ,the differences were statistically significant(P< 0 .05) .BAP of the two group were decreased after treatment ,but the decrease in the control group was more obvious ,the difference compared with the experimental group had statistical significance(P< 0 .05) .ALB ,BUN and SCr after treatment in the two group had no obvious improvement ,the differences between groups were not statistically significant (P>0 .05) .Conclusion In the combination with hemodiafiltration for treating renal osteodystrophy ,low dose of calcitriol can achieve the same effect as high dose ,but has much less adverse reactions and better safety .