王光林　苏晓华

[摘要] 目的 研究慢性腎功能不全患者肾性骨病应用骨化三醇治疗的临床疗效，并分析其安全性。 方法 选择2014年7月～2016年11月期间所收治的68例肾性骨病患者作为本次研究病例，对患者进行分组治疗，采用随机数字表法进行分组，对照组和研究组各34例，对照组患者应用常规治疗方法，研究组在此基础上加用骨化三醇治疗，对比分析两组患者的临床各项指标，并分析其不良反应发生情况。 结果 治疗前，两组临床指标无明显统计学意义（P>0.05），经治疗后，研究组患者的血清钙水平为（2.31±0.15）mmol/L，血清无机磷水平为（1.89±0.14）mmol/L，甲状旁腺激素为（202.01±35.87）pg/mL，碱性磷酸酶为（80.46±2.85）U/L，其中血清钙、血清无机磷与甲状旁腺激素水平与对照组比较具有统计学意义（t=4.1607、3.1260、5.7254，P<0.05），碱性磷酸酶与治疗前比较无统计学意义（t=1.3055，P>0.05）；研究组患者不良反应发生率为8.82%（3例），对照组患者不良反应发生率为14.71%（5例），两组患者不良反应比较无统计学意义（χ2=0.5667，P>0.05）。 结论 慢性肾功能不全患者肾性骨病中应用骨化三醇治疗的效果明显，能够有效改善患者的临床症状，改善钙磷紊乱情况，并且不良反应少，可以在临床中推广使用。

[关键词] 骨化三醇；慢性肾功能不全；肾性骨病；安全性

[中图分类号] R692.5 [文献标识码] B [文章编号] 1673-9701（2018）15-0078-03

The effect of calcitriol on treating renal osteodystrophy in patients with chronic renal insufficiency

WANG Guanglin1 SU Xiaohua2

1.Department of Second Orthopedics， Laiwu Central Hospital， Xinwen Mining Group， Laiwu 271103， China； 2.Dialysis Room， Laiwu Central Hospital， Xinwen Mining Group， Laiwu 271103， China

[Abstract] Objective To study the clinical efficacy of calcitriol in the treatment of renal osteodystrophy in patients with chronic renal insufficiency and to analyze its safety. Methods 68 patients with renal osteodystrophy admitted from July 2014 to November 2016 were selected as participants. The patients were divided into control group and study group with 34 cases in each group using random number table. Patients in the control group were treated with routine treatment. The study group was additionally treated with calcitriol on the basis of routine treatment. The clinical indicators of the two groups were compared and analyzed， and the incidence of adverse reactions was analyzed. Results Before treatment， there was no significant difference in clinical parameters between the two groups（P>0.05）. After treatment， the serum calcium level in the study group was（2.31±0.15） mmol/L， the serum inorganic phosphorus level was（1.89±0.14）mmol/L， parathyroid hormone was（202.01±35.87） pg/mL， alkaline phosphatase was （80.46±2.85） U/L， of which the serum calcium， serum inorganic phosphorus and parathyroid hormone levels were statistically significant different with the control group（t=4.1607， 3.1260， 5.7254， P<0.05）， while alkaline phosphatase has no significance（t=1.3055， P>0.05）. The incidence of adverse reactions in the study group was 8.82%（3 cases） and the control group was 14.71%（5 cases）， there was no statistically significant difference between the two groups（χ2=0.5667， P>0.05）. Conclusion The use of calcitriol in the treatment of renal bone disease in chronic renal insufficiency patients has obvious effect. It can effectively improve the patient's clinical symptoms， improve calcium and phosphorus disorders， and has fewer adverse reactions， which can be promoted in clinical use.

[Key words] Calcitriol； Chronic renal insufficiency； Renal bone disease； Safety

肾性骨病属于一种常见的肾病并发症，其发病机制主要为患者自身机体血清钙等代谢异常引起[1]，该种疾病对患者生活具有严重影响，并威胁患者生命安全。传统治疗中，一般依靠降压治疗、降糖治疗、纠正酸中毒等综合疗法进行，但治疗效果并不十分明显，近几年，……