骨化三醇治疗慢性肾脏病非透析患者继发性甲状旁腺功能亢进的疗效观察

摘要

[目的]观察骨化三醇治疗慢性肾脏病非透析患者继发性甲状旁腺功能亢进的疗效.[方法]选择2008年5月到2010年8月本科收治的30例尚未进入替代治疗的慢性肾脏病(CKD4,5期)合并继发性甲状旁腺功能亢进的患者作为研究对象,根据血清全段甲状旁腺激素(iPTH)水平确定骨化三醇[1,25-(OH)2-D3]的给药剂量,监测治疗前及治疗后4、8和12周时的血钙、血磷水平及血清iPTH的水平及临床症状的缓解情况.[结果]至治疗终点12周时,血Ca、血P和Ca×P与治疗前比较差异均无统计学意义(P＞0.05);血iPTH在治疗后4周、8周和12周呈持续下降趋势,与治疗前比较,差异均有统计学意义(P＜0.05).观察期间均未发生明显副反应.[结论]骨化三醇治疗慢性肾脏病非透析患者继发性甲状旁腺功能亢进患者疗效显著,临床症状改善明显.%[Objective]To observe the efficacy of calcitriol for the treatment of non-dialysis chronic kidney disease patients with secondary hyperparathyroidism.[Methods]Thirty cases of chronic kidney disease (CKD4,5 period) with secondary hyperparathyroidism from May 2008 to August 2010 were taken as research subjects.According to serum whole immunoreactive parathyroid hormone(iPTH) level, the dosage of calcitriol [1,25-(OH)2-D3]was determined.Blood calcium(Ca), phosphorus(P), iPTH levels and clinical symptoms before and 4, 8 and 12 weeks after treatment were monitored.[Results]At the end of 12-week treatment,blood Ca, P and Ca × P showed no significant difference compared with those before treatment( P ＞0.05).The iPTH at 4, 8 and 12 weeks after treatment showed a declining trend and had significant difference com pared with those before treatment ( P ＜ 0.05).No obvious adverse reaction occurred during treatment.[Conclusion]Calcitriol for the treatment of non-dialysis chronic kidney disease patients with secondary hyper parathyroidism has significant efficacy with obvious clinical improvement.