Objective To investigate the effect of lanthanum carbonate combined calcium acetate in maintaining he-modialysis patients.Methods Seventy-eighy cases of maintenance hemodialysis patients in Mianyang Central Hospital from December 2014 to January 2009 were randomly divided into 3 groups:lanthanum carbonate group (16 cases), calcium acetate group (37 cases) and lanthanum carbonate group ( combined group 25 cases) .Treatment of 12 weeks, compared the 3 groups of patients'calcium and phosphorus metabolism.Results ( 1 ) Calcium and phosphorus metabolism: Compared with before treatment, serum calcium levels after 12 weeks in the three groups showed no significant changes, the difference was not statis-tically significant ( P >0.05), serum phosphorus, serum calcium and phosphorus product parathyroid hormone (iPTH) were significantly lower, the difference was statistically significant (lanthanum carbonate group:t =5.88,2.22,6.20,calcium ace-tate group:t =5.11,3.28,6.02, combined group:t =10.08,6.90,9.33, P <0.05), which reduced most obvious in com-bination group ( F =6.88, F =5.86, F =3.54, P <0.05).(2)Renal function and Hb levels:compared with before treat-ment, after 12 weeks of treatment, these indices were significantly decreased in 3 groups, the difference was statistically sig-nificant (lanthanum carbonate group:t =3.04,4.02,calcium acetate group:t =4.85,4.04,combined group:t =4.93, 3.37, P <0.05), while Alb and Hb levels had no significant differences ( P >0.05);among the three groups, before and after treatment, the indicators showed no significant differences ( P >0.05).(3)Ultrasound:3 groups of patients before and after treatment of carotid intimal thickening and plaque formation ratio's difference did not show statistically significant ( P >0.05).Conclusion Lanthanum carbonate combined with calcium acetate can be used in the treatment of chronic kidney dis-ease hemodialysis patients with high phosphorus, it can effectively reduce the level of serum phosphorus and PTH.%目的 观察碳酸镧联合醋酸钙对维持性血液透析患者钙磷代谢的影响.方法 选取2009年1月—2014年12月绵阳市中心医院维持性血液透析高磷血症患者78例,采用简单随机化分组法分为碳酸镧组(16例)、醋酸钙组(37例)和碳酸镧联合醋酸钙组(联合组,25例).治疗12周,比较3组患者的钙磷代谢情况.结果 (1)钙磷代谢指标:与治疗前比较,治疗12周后3组患者血钙水平均无显著变化,差异均无统计学意义(P>0 p.05),血磷、钙磷乘积及血清甲状旁腺激素(iPTH)均显著降低,差异均有统计学意义(t碳酸镧组=5.88、2.22、6.20,t醋酸钙组=5.11、3.28、6.02,t联合组=10.08、6.90、9.33,P<0.05),其中以联合组降低最明显(F=6.88、5.86、3.54,P<0.05).(2)肾功能指标及Hb水平:与治疗前比较,治疗12周后3组患者SCr和BUN水平均显著下降,差异有统计学意义(t碳酸镧组=3.04、4.02,t醋酸钙组=4.85、4.04,t联合组=4.93、3.37,P<0.05),而Alb和Hb水平差异无统计学意义(P>0.05);治疗前后3组间比较,各项指标差异均无统计学意义(P>0.05).(3)彩色超声检查:3组患者治疗前后颈动脉内膜增厚和斑块形成比例差异均无统计学意义(P>0.05).结论 碳酸镧联合醋酸钙可用于治疗慢性肾脏病血液透析患者高磷血症,有效降低血磷、PTH水平.
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