王军涛



骨化三醇对非透析慢性肾脏病继发性甲状旁腺功能亢进患者血压的影响

王军涛

【摘要】目的 分析研究骨化三醇对非透析慢性肾脏病继发性甲状旁腺功能亢进患者血压的影响。方法 抽取2014年1月～2015年1月我院接收的60例非透析慢性肾脏病继发性甲状旁腺功能亢进患者，将24 h平均血压大于130 mm Hg/80 mm Hg的患者分为观察组（30例），24 h平均血压值正常者作为对照组（30例），均服用骨化三醇治疗，观察治疗前后血压变化。结果 治疗前，观察组24 h平均舒张压、平均收缩压、平均舒张压、舒张压下降率、收缩压下降率与对照组相比差异均有统计学意义（P＜0.05），治疗后，观察组各项指标与对照组相比差异无统计学意义（P＞0.05）；2组患者治疗前血清iPTH、血钙和血磷水平相比差异无统计学意义（P＞0.05），治疗后1个月、2个月、3个月时两组各项指标均优于治疗前，差异有统计学意义（P＜0.05）。结论 采用骨化三醇治疗非透析慢性肾脏病继发性甲状旁腺功能亢进患者效果良好，可有效改善其血清及血钙、血磷水平，恢复血压值，具有一定临床价值。

【关键词】骨化三醇；非透析慢性肾脏病；血压

Objective To study the effect of calcitriol on blood pressure in patients with chronic kidney disease of non dialysis chronic kidney disease. Methods 60 non dialysis chronic kidney disease patients with secondary parathyroid function from January 2014 to January 2015 in our hospital were divided into two groups，24 h mean blood pressure above 130.0 mm Hg/80.0 mm Hg were divided into observation group（30 cases），and the average blood pressure of 24h was normal as control group（30 cases），All were treated with calcitriol. Blood pressure changes before and after treatment were observed. Results Before treatment，the average diastolic blood pressure，mean systolic blood pressure，mean diastolic blood pressure，diastolic blood pressure drop rate，and the control group had significant difference compared with the control group（P＜0.05）. After treatment，there was no significant difference between the observation group and the control group（P＞ 0.05）. Two groups of patients with treatment，the levels of serum iPTH，calcium and phosphorus levels compared to the difference was not statistically significant（P＞0.05）. After treatment，1 month，2 months，3 months each index of the two groups were significantly higher than those before treatment，the difference was statistically significant（P＜0.05）. Conclusion Calcitriol in treatment of non dialysis chronic kidney disease secondary hyperparathyroidism patients has effect significantly，can effectively improve the serum and serum calcium，serum phosphorus level，restore blood pressure value，has a certain clinical value.

【Key words】 Calcitriol，Non dialysis chronic kidney disease，Blood pressure

继发性甲状旁腺功能亢进是一种多发于慢性肾脏病患者的并发症，并且慢性肾脏病患者多伴有血压节律异常及高血压等症状［1-2］。大量临床资料表明［3-4］，血压和血压节律变化情况与甲状腺素密切相关。传统治疗继发性甲状旁腺功能亢进的药物为维生素D，但国内外尚未见关于此药物对血压及血压节律调节效果的研究报道［5］。……