方岳军，李传英新疆沙雅县人口和计划生育生殖健康服务站，新疆沙雅　842200

骨化三醇冲击治疗量对慢性肾功能衰竭早期钙磷代谢紊乱的影响研究

方岳军，李传英
新疆沙雅县人口和计划生育生殖健康服务站，新疆沙雅842200

目的研究慢性肾衰患者早期钙磷代谢紊乱给予骨化三醇冲击治疗的临床效果。方法 整群选取并回顾分析2013年7月—2014年7月于该科治疗的95例出现早期钙磷代谢紊乱的慢性肾衰患者临床资料，依据治疗方式将其分为实验组（n=48）与对照组（n=47），两组均予腹膜透析，对照组晚睡前予0.5 μg骨化三醇口服，1次/d，实验组晚睡前予2.0 μg骨化三醇口服，2次/周，两组治疗均持续3个月，观察对比两组治疗前后FGF23（细胞成纤维生长因子）、iPTH（全段甲状旁腺激素）、血磷、矫正钙浓度、钙磷乘积水平的改变情况。结果 实验组治疗前FGF23、iPTH、血磷、矫正钙浓度、钙磷乘积水平与对照组对比，差异无统计学意义（P＞0.05），治疗后FGF23水平为（83.75±7.72）RU/mL、iPTH水平为（353.83±85.39）ng/L均降低，差异有统计学意义（P＜0.05），血磷（7.58±1.01）RU/mL、矫正钙浓度（8.52± 1.64）ng/L、钙磷乘积水平（48.25±5.78）ng/L，均较对照组升高明显，差异有统计学意义（P＜0.05）。结论 慢性肾衰竭腹膜透析早期钙磷紊乱者应用骨化三醇冲击治疗，通过降低FGF23、iPTH水平，能够改善钙、磷代谢，效果显著，应予推广。

慢性肾衰；钙磷代谢；骨化三醇；冲击治疗；疗效

［Abstract］Objective To study the clinical effect of early calcium and phosphorus metabolism disorder in patients with chronic renal failure.Changes in the level of FGF23，three ossification of late.Methods Group selection and retrospective analysis of 2013 to 2014 years in our department treated early calcium and phosphorus metabolism in chronic renal failure patients 95 cases of clinical data，treatment based on the divided into experimental group（n=48）and control group（n=47）. Two groups were treated with peritoneal dialysis，the control group given before 0.5 μg ossification alcohol orally，1 time/ day，the experimental group of late before giving the 2.0 μg alcohol of oral 2 times/week，two groups of treatment lasted for 3 months，were compared between the two groups before and after treatment（cell fibroblast growth factor），parathyroid hormone（intact parathyroid hormone and serum phosphorus，correction of calcium concentration and calcium phosphorus product.Results The experimental group in the treatment of FGF23，iPTH，serum phosphorus，correction calcium concentration，the level of calcium phosphorus product and control group comparison，no statistical significance（P＞0.05），the treatment after FGF23 levels for（83.75±772）RU/mL，iPTH levels for（353.83±85.39）ng/L were lower（P＜0.05），phosphorus（7.58±1.01）RU/mL，correct calcium concentration（8.52±1.64）ng/L，the product of calcium and phosphate levels（48.25±5.78）ng/L，were lower than those in the control group increased significantly（P＜0.05）.Conclusion Application of three alcohol in the treatment of chronic renal failure in patients with chronic renal failure peritoneal dialysis calcium phosphate，by reducing the level of iPTH，FGF23，can improve calcium and phosphorus metabolism，the effect is significant，should be promoted.

［Key words］Chronic renal failure；Calcium and phosphorus metabolism；Ossification of three alcohol；Impact therapy；Therapeutic effect

慢性肾衰竭患者可出现甲状旁腺继发性功能亢进（SHPT），SHPT属于透析治疗阶段的严重并发症。研究显示，肾脏骨化三醇生成障碍、早期钙磷代谢紊乱为SHPT的关键因素。该文研究2013年7月—2014年7月于我科治疗的48例出现早期钙磷代谢紊乱的慢性肾衰早期钙磷代谢紊乱患者给予2.0 μg骨化三醇冲击治疗的临床效果，旨在为制定合理化、规范化治疗方案提供客观依据，现报道如下。……