文章摘要

维持性血液透析应用碳酸镧治疗的疗效及对钙磷代谢、全段甲状旁腺激素、冠状动脉钙化积分的影响

作者: 1张甜甜, 1刘正亮
1 阜阳市第二人民医院血液净化科,安徽 阜阳 236015
通讯: 张甜甜 Email: 358670637@qq.com
DOI: 10.3978/j.issn.2095-6959.2021.03.016

摘要

目的:探讨维持性血液透析应用碳酸镧治疗的疗效以及对钙磷代谢、全段甲状旁腺激素(intact parathyroid hormone,iPTH)、冠状动脉钙化积分(coronary artery calcification score,CACs)的影响,为患者诊疗提供依据。方法:选择2019年6月1日至12月1日收治的80例维持性血液透析高磷血症患者,采用随机数表法分为观察组和对照组,每组40例。对照组采用醋酸钙胶囊治疗,观察组在此基础上采用碳酸镧治疗。治疗3个月后比较效果,记录治疗前后钙磷代谢、钙化积分及白细胞介素-6(interleukin-6,IL-6)、C反应蛋白(C reactive protein,CRP)、血清肿瘤坏死因子-α(serum tumor necrosis factor-α,TNF-α)变化,统计不良反应。结果:治疗后,观察组总有效率为92.50%,明显高于对照组的75.00%,差异有统计学意义(P<0.05);治疗后,两组血钙、血磷、CACs、iPTH水平均明显降低,且观察组明显低于对照组,差异有统计学意义(P<0.05);治疗后,两组患者的IL-6、TNF-α、CRP均明显下降,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应比较,差异无统计学意义(P>0.05)。结论:碳酸镧治疗维持性血液透析患者效果明显,可有效改善患者血钙、血磷、iPTH、CACs水平及微炎症状态,安全性高,值得临床推广应用。
关键词: 维持性血液透析;碳酸镧;钙磷代谢;全段甲状旁腺激素;冠状动脉钙化积分;不良反应

Therapeutic effect of lanthanum carbonate therapy on maintenance hemodialysis and its effect on calcium and phosphorus metabolism, full parathyroid hormone, and coronary artery calcification score

Authors: 1ZHANG Tiantian, 1LIU Zhengliang
1 Department of Blood Purification, Fuyang Second People’s Hospital, Fuyang Anhui 236015, China

CorrespondingAuthor: ZHANG Tiantian Email: 358670637@qq.com

Abstract

Objective: To explore the effect of lanthanum carbonate therapy on maintenance hemodialysis and its effect on calcium and phosphorus metabolism, intact parathyroid hormone (iPTH), coronary artery calcification score (CACs), and provide basis of diagnosis and treatment for patients. Methods: Eighty patients with maintenance hemodialysis hyperphosphatemia admitted from June 1, 2019 to December 1, 2019 were selected and randomly divided into an observation group and a control group (40 cases in each group). The control group was treated with calcium acetate capsules, and the observation group was treated with lanthanum carbonate on this basis. The effect was compared after 3 months of treatment; changes of calcium and phosphorus metabolism, calcification score, interleukin-6 (IL-6), C reactive protein (CRP), and serum tumor necrosis factor-α (TNF-α) were recorded before and after treatment, and adverse reactions were counted. Results: After the treatment, the total effective rate in the observation group was 92.50%, significantly higher than that in the control group (75.00%), and the difference was statistically significant (P<0.05). After the treatment, the blood calcium, blood phosphorus, CACs, and iPTH of the two groups were significantly reduced, and those in the observation group were significantly lower than those in the control group; the differences were statistically significant (P<0.05). After the treatment, the IL-6, TNF-α and CRP of the two groups were significantly decreased, and those in the observation group were lower than those in the control group; the differences were statistically significant (P<0.05); there was no statistically significant difference in adverse reactions between the two groups (P>0.05). Conclusion: Lanthanum carbonate has an obvious effect in the treatment of maintenance hemodialysis, which can effectively improve the levels of blood calcium, blood phosphorus, iPTH, CACs and micro-inflammatory state of patients, with high safety and worthy of clinical promotion and application.
Keywords: maintenance hemodialysis; lanthanum carbonate; calcium and phosphorus metabolism; intact parathyroid hormone; coronary artery calcification score; adverse reactions