The study of calcitriol,cinacalcet combined with nursing intervention effect of SHPT, calcium, phosphorus metabolism and parathyroid hormone on MHD patients

摘要

Objective:To investigate calcitriol, cinacalcet plus comprehensive intervention on maintenance hemodialysis (MHD) patients with secondary hyperparathyroidism (SHPT) calcium (Ca), phosphorus (P) metabolism and parathyroid hormone (PTH) effect.Methods: A total of 80 cases of patients with SHPT from January 2014 to January 2016 in our hospital were randomly divided into observation group and control group, control group to eat the whole piece of cinacalcet hydrochloride oral tablets, the initial dose of 25 mg/d, every 2 to 4 weeks, according to Ca×P, parathyroid hormone (iPTH) test results adjust the dose, the maximum dose of not more than 75 mg/d, the observation group in the control group on the basis of oral administration of Calcitriol Soft Capsules 0.25 g/d, 3 times/week, 2 groups were given comprehensive intervention measures, to evaluate the curative effect after 3 months of treatment. The 2 groups before and after treatment collected fasting peripheral venous blood, the determination of Ca, P and alkaline phosphatase by colorimetric method (ALP), Ca, P product calculation (Ca×P), to detect the level of iPTH before and after treatment by ELISA method; TY-6858-HI type ultrasound instrument, measuring length, width and thickness of the parathyroid glands, and calculate the parathyroid gland volume.Results:in the observation group after treatment, Ca, Ca×P increased degree, P, ALP, iPTH lower than the control group, the size of the parathyroid gland was better than the control group.Conclusion:calcitriol, cinacalcet combined intervention therapy has good clinical effect in patients with MHD SHPT, Ca, P can effectively improve the metabolism, reduce the level of iPTH, reduce the parathyroid gland volume is worthy of promotion.