西那卡塞对维持性腹膜透析患者骨质疏松的影响-现代医学

西那卡塞对维持性腹膜透析患者骨质疏松的影响

单位：张家港市中医医院肾病科, 江苏张家港 215600

分类号：R459.5;R58

出版年·卷·期（页码）：2019·47·第三期（329-332）

摘要：

目的：探讨西那卡塞对维持性腹膜透析患者骨质疏松的影响。方法：收集张家港市中医医院2015年2月至2017年7月治疗的维持性腹膜透析伴发骨质疏松患者108例。使用随机数表法将患者分为观察组和对照组，每组54例。对照组：口服碳酸钙600~1 800 mg·d^-1，骨化三醇0.25~0.50 μg·d^-1，观察组在对照组基础上加用西那卡塞，25 mg·d^-1，疗程6个月。结果：疗程结束后对照组和观察组血BUN和Scr无显著性差异（P>0.05），观察组血Ca、P、iPTH和ALP变化率分别为（27.86±2.64）%、（29.35±3.12）%、（41.75±4.53）%和（46.82±5.07）%，显著高于对照组的（16.72±1.72）%、（18.42±1.96）%、（20.94±2.14）%和（22.73±2.38）%（P<0.01）。疗程结束后观察组BMD、VAS和WOMAC变化率分别为（58.18±6.13）%、（45.79±5.02）%和（38.71±4.78）%，均显著高于对照组的（38.30±3.76）%、（24.33±2.45）%和（24.06±2.77）%（P>0.01）。对照组不良反应发生率为11.11%，观察组不良反应发生率为12.96%，两组不良反应发生率差异无统计学意义（P>0.05）。结论：西那卡塞可以调节维持性腹膜透析骨质疏松患者的钙、磷代谢，显著改善患者骨质疏松症状。

Objective:To detect the effect of cinacalcet on osteoporosis in patients with maintenance peritoneal dialysis. Methods:One hundred and eight continuous ambulatory peritoneal dialysis patients with osteoporosis were enrolled in this study. The patients were divided into:the control group(n=54) and observation group(n=54). The control group was treated with calcium carbonate 600-1 800 mg·d^-1 and calcitriol 0.25-0.50 g·d^-1. The observation group was added cinacalcet 25 mg·d^-1 on the basis of the control group for 6 monthes. Results:After treatment, there was no significant difference in blood BUN and Scr between the control group and the observation group (P>0.05). The change rate of blood Ca, P, iPTH and ALP in the observation group were(27.86±2.64)%, (29.35±3.12)%, (41.75±4.53)%, and(46.82±5.07)%, respectively. Which were significantly higher than those of(16.72±1.72)%, (18.42±1.96)%, (20.94±2.14)%, and (22.73±2.38)% in the control group (P<0.01). The change rate of blood BMD, VAS and WOMAC in the observation group were (58.18±6.13)%, (45.79±5.02)%, and(38.71±4.78)%, which were significantly higher than those of(38.30±3.76)%, (24.33±2.45)%, and(24.06±2.77)% in the control group (P<0.01). The incidence of adverse reactions in the control group was 11.11%, and which was 12.96% in theobservation group. There was no significant difference between the two groups (P>0.05). Conclusion:Cinacalcet can regulate calcium and phosphorus metabolism in patients with persistent peritoneal dialysis andimprove significantly the symptoms of osteoporosis.

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