碳酸镧治疗血液透析患者顽固性高磷血症的前瞻性观察

摘要

Objective: To assess the efficacy and side effects of lanthanum carbonate in maintenance hemodialysis (MHD) patients with refractory hyperphosphatemia. Methods: Sixteen MHD patients with refractory hyperphosphatemia were pre-scribed with lanthanum carbonate 500 mg for 4 weeks, three times a day in mealtime. The serum phosphorus was examined before and after treatment and the side effects was also observed. Results: After treatment, serum phosphorus decreased sig-nificantly from (2.99±0.26) mmol/L to (1.94±0.28) mmol/L (P<0.05). The serum calcium,and serum parathyroid hormone show no obvious variation(P>0.05). The side effects of lanthanum carbonate were weak, only 2 patients feel sick to their stomach. No patient interrupted therapy and no serious adverse events were observed. Conclusion: The management of hyperphos-phatemia with lanthanum carbonate in MHD patients is safe and effective.%目的：观察碳酸镧治疗血液透析患者顽固性高磷血症的有效性和安全性。方法：选择16例存在顽固性高磷血症的维持性血液透析(maintenance hemodialysis，MHD)患者，每日3餐餐中予嚼服碳酸镧咀嚼片500 mg，4周后对血磷水平进行分析评估，并观察不良反应。结果：患者口服碳酸镧4周后血磷水平明显下降，血清磷水平由服药前(2.99±0.26) mmol/L降为(1.94±0.28) mmol/L(P<0.05)，而血清钙、甲状旁腺激素等指标在治疗前后并无明显变化(P>0.05)。在服用碳酸镧过程中，2例患者出现轻微的胃部不适感，但无1例患者因严重的不良反应中断治疗。结论：碳酸镧能够安全和有效地降低MHD患者的血磷水平。