骨化三醇注射液治疗慢性肾功能衰竭肾性骨病患者的疗效观察

王夏莲，石丽丽

（西安市华山中心医院肾脏内科，陕西 西安，710043）

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摘要：

目的 探究骨化三醇注射液对慢性肾功能衰竭肾性骨病患者继发性甲状旁腺功能亢进的治疗效果。方法 选择本院慢性肾功能衰竭肾性骨病并继发性甲状旁腺功能亢进患者60例，随机分为观察组和对照组，各30例。观察组静脉注射骨化三醇，对照组口服骨化三醇。治疗3个月，比较两组患者的血钙、血磷、全段甲状旁腺激素、碱性磷酸酶水平及不良反应发生情况。结果 治疗后，两组患者血磷、全段甲状旁腺激、碱性磷酸酶浓度降低（P<0.05），对照组患者血钙升高（P<0.05），且观察组患者全段甲状旁腺激素和血钙浓度低于对照组（P<0.05）。对照组不良反应发生率为13.33%，高于观察组的0.00%（P<0.05）。结论 骨化三醇能缓解患者机体钙、磷及维生素D的代谢功能紊乱，静脉注射骨化三醇能有效降低全段甲旁腺激素水平，减少高钙血症发生，应作为首选用药方式。

关键词：骨化三醇；慢性肾功能衰竭；肾性骨病；继发性甲状旁腺功能亢进

中图分类号：R692.5文献标志码：A文章编号：2096-1413(2017)20-0011-02

Efficacy of calcitriol injection in the treatment of chronic renal failure with renal osteopathy
WANG Xia-lian, SHI Li-li
(Department of Kidney Internal Medicine, Huashan Center Hospital, Xi``an 710043, China)

ABSTRACT: Objective To investigate the effect of calcitriol injection on secondary hyperparathyroidism in patients with chronic renal failure and renal osteopathy. Methods Sixty cases of patients with secondary hyperparathyroidism combined with chronic renal failure and renal osteopathy were selected and randomly divided into observation group (n =30) and control group (n=30). The observation group used calcitriol by intravenous injection, while the control group used calcitriol orally. After 3 months of treatment, the levels of serum calcium, serum phosphorus, total parathyroid hormone, alkaline phosphatase and adverse reactions were compared in the two groups. Results After treatment, the levels of serum phosphorus, total parathyroid hormone and alkaline phosphatase decreased in both groups (P<0.05), the level of serum calcium was elevated in the control group (P<0.05), and the levels of alkaline phosphatase and serum calcium in the observation group were lower than those in the control group (P<0.05). The incidence rate of adverse reaction in the control group was 13.33%, which was higher than 0.00% in the observation group (P<0.05). Conclusion Calcitriol can relieve the metabolic dysfunction of calcium, phosphorus and vitamin D in patients, intravenous injection of calcitriol can effectively reduce the level of total parathyroid hormone and the incidence of hypercalcemia, which should be used as the preferred mode of medication.
KEYWORDS: calcitriol; chronic renal failure; renal osteodystrophy; secondary hyperparathyroidism

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