丘宝珍

【摘要】 目的：研究帕立骨化醇与骨化三醇对继发性甲状旁腺功能亢进症的治疗效果及对安全性的影响。方法：选取笔者所在医院2016年1月-2019年1月收治的90例继发性甲状旁腺功能亢进症患者，利用等距随机抽样法将其分为对照组及观察组，各45例。对照组采取骨化三醇治疗，观察组采取帕立骨化醇治疗，比较两组临床治疗效果、安全性。结果：治疗前两组全段甲状旁腺激素、碱性磷酸酶、血钙、血磷水平比较，差异均无统计学意义（P>0.05）;治疗后全段甲状旁腺激素、碱性磷酸酶、血磷均较治疗前降低，血钙较治疗前升高，差异均有统计学意义（P<0.05），且观察组各指标均优于对照组，差异有统计学意义（P<0.05）。观察组不良反应发生率低于对照组，治疗满意度高于对照组，差异均有统计学意义（P<0.05）。结论：相较于骨化三醇，帕立骨化醇在继发性甲状旁腺功能亢进症的治疗中效果更佳，安全性更高，可作为优选用药推广使用。

【关键词】 继发性甲状旁腺功能亢进症 帕立骨化醇 骨化三醇 安全性

doi：10.14033/j.cnki.cfmr.2019.30.006 文献标识码 A 文章编号 1674-6805（2019）30-00-03

[Abstract] Objective： To study the efficacy and safety of Parecalcitol and Calcitriol in the treatment of secondary hyperparathyroidism. Method： A total of 90 patients with secondary hyperparathyroidism admitted in our hospital from January 2016 to January 2019 were selected. They were divided into the control group and the observation group by isometric random sampling method， with 45 cases in each group. The control group was treated with Calcitriol， and the observation group was treated with Palicalcitol. The clinical efficacy and safety of the two groups were compared. Result： There were no significant differences in the levels of whole parathyroid hormone， alkaline phosphatase， blood calcium and blood phosphorus between the two groups before treatment （P>0.05）. After treatment， the levels of whole parathyroid hormone， alkaline phosphatase and blood phosphorus were lower than those before treatment， and the levels of blood calcium were higher than those before treatment， the differences were statistically significant （P<0.05）， and the indexes in the observation group were better than those in the control group， the differences were statistically significant （P<0.05）. The incidence of adverse reactions in the observation group was lower than that in the control group， and the treatment satisfaction was higher than that in the control group， the differences were statistically significant （P<0.05）. Conclusion： Compared with Calcitriol， Palicalcitol is more effective and safe in the treatment of secondary hyperparathyroidism， and can be widely used as an optimal drug.

[Key words] Secondary hyperparathyroidism Palikalitol Calcitriol Safety

First-authors address： Meizhou Peoples Hospital， Meizhou 514031， China

血液透析是目前終末期肾病患者常用的治疗手段[1]。通过将体内血液经由血管通路引至透析机内，利用透析器内透析膜完成水分及代谢废弃物的交换后重新输回体内以实现排除多余水分、维持机体水电解质平衡、延长生存周期的目的[2-3]。尽管血液透析能够取得理想效果但在治疗期间容易并发多种并发症，其中尤以继发性甲状旁腺功能亢进症[4-5]。根据统计显示，Ⅳ期慢性肾脏病患者中继发性甲状旁腺功能亢进症者高达70.00%[6-7]。目前国际上主流的《慢性肾脏病及透析的临床实践指南》推荐维生素D受体激动剂为继发性甲状旁腺功能亢进症首选用药[8-9]。随着医药产业的快速发展，维生素D受体激动剂种类越发多样，本研究比较帕立骨化醇与骨化三醇对继发性甲状旁腺功能亢进症的治疗效果及对安全性的影响，现报道如下。