林志鹏

【摘要】 目的：探討碳酸镧对维持性血液透析患者高磷血症疗效的影响。方法：选取2020年7-12月本院收治的50例维持性血液透析伴高磷血症患者，随机分为两组，每组25例。对照组采取碳酸钙治疗，研究组采取碳酸镧治疗。比较两组治疗前后血P、Ca、iPTH水平、LVMI、冠状动脉钙化积分及治疗后总有效率和不良反应发生情况。结果：研究组治疗总有效率高于对照组（字2=4.150，P=0.042）。研究组治疗后的血P、Ca水平均低于对照组（t=3.214，P=0.002;t=5.121，P=0.000）。研究组治疗后的血P、Ca水平均低于治疗前（t=4.914，P=0.000;t=2.241，P=0.030）。对照组治疗后的血P、Ca水平均低于治疗前（t=2.143，P=0.037;t=2.407，P=0.020）。两组治疗前后iPTH水平比较，差异均无统计学意义（P>0.05）。研究组不良反应发生率明显低于对照组（字2=4.500，P=0.034）。研究组治疗后LVMI、冠状动脉钙化积分均高于治疗前，但差异均无统计学意义（t=0.876，P=0.385;t=0.445，P=0.659）;对照组LVMI、冠状动脉钙化积分均高于治疗前（t=2.996，P=0.004;t=2.749，P=0.008）。研究组治疗后LVMI、冠状动脉钙化积分均低于对照组（t=2.030，P=0.048;t=2.073，P=0.044）。结论：碳酸镧治疗维持性血液透析高磷血症患者的效果显著，可降低血磷、血钙水平，且具有较高的用药安全性，还能避免患者左心室肥厚及冠状动脉钙化，值得推广应用。

【关键词】 碳酸镧 维持性血液透析 高磷血症 左心室肥厚 冠状动脉钙化

Effect of Lanthanum Carbonate on Hyperphosphatemia in Maintenance Hemodialysis Patients/LIN Zhipeng. //Medical Innovation of China， 2021， 18（12）： 0-057

[Abstract] Objective： To explore the effect of Lanthanum Carbonate on hyperphosphatemia in maintenance hemodialysis patients. Method： A total of 50 patients with maintenance hemodialysis and hyperphosphatemia admitted to our hospital from July to December 2020 were selected for the study， and they were randomly divided in two groups， 25 patients in each group. The control group was treated with Calcium Carbonate， and the study group was treated with Lanthanum Carbonate. The blood P， Ca， iPTH levels， LVMI， coronary artery calcification score before and after treatment were compared between two groups， and the total effective rate and adverse reactions of two groups after treatment were compared. Result： The total effective rate of treatment in the study group was higher than that in the control group （字2=4.150， P=0.042）. The blood P and Ca levels of the study group after treatment were lower than those of the control group （t=3.214， P=0.002; t=5.121， P=0.000）. The blood P and Ca levels of the study group after treatment were lower than those of before treatment （t=4.914， P=0.000; t=2.241， P=0.030）. The blood P and Ca levels of the control group after treatment were lower than those of before treatment （t=2.143， P=0.037; t=2.407， P=0.020）. There were no significant differences in the levels of iPTH between two groups before and after treatment（P>0.05）. The incidence of adverse reactions in the study group was significantly lower than that in the control group （字2=4.500， P=0.034）. The LVMI and coronary artery calcification score of the study group after treatment were higher than those of before treatment， but the differences were not statistically significant （t=0.876， P=0.385; t=0.445， P=0.659）. The LVMI and coronary artery calcification scores in the control group were higher than those of before treatment （t=2.996， P=0.004; t=2.749， P=0.008）. The LVMI and coronary artery calcification scores of the study group after treatment were lower than those of the control group （t=2.030， P=0.048; t=2.073， P=0.044）. Conclusion： Lanthanum Carbonate is effective in treating patients with maintenance hemodialysis hyperphosphatemia. It can reduce blood phosphorus and calcium levels， and has high drug safety. It can also avoid left ventricular hypertrophy and coronary artery calcification in patients， it is worthy of popularization and application.

[Key words] Lanthanum Carbonate Maintenance hemodialysis Hyperphosphatemia Left ventricular hypertrophy Coronary artery calcification

First-authors address： The Second Peoples Hospital of Jiedong District in Jieyang City， Jieyang 515549， China

doi：10.3969/j.issn.1674-4985.2021.12.012

维持性血液透析是治疗肾功能衰竭常见方法，其能够清除患者机体内的毒素，并纠正机体电解质紊乱[1]。高磷血症是维持性血液透析患者的常见并发症，其与软组织和血管钙化有一定的相关性，可引发血管钙化及骨质疏松等并发症，提高了患者的病死率，不利于预后[2]。目前，临床上常采用铝、钙及镁制剂治疗尿毒症血液透析高磷血症，但长期使用此类药物治疗会增加患者便秘、高钙血症及腹泻的发生率[3]。碳酸……