目的 探讨西那卡塞联合骨化三醇、司维拉姆（三联疗法）对血液透析合并三发性甲状旁腺功能亢进（tertiary hyperparathy-roidism,THPT）患者的疗效。方法 纳入120例新疆四七四医院2021年1月—2024年7月收治的血液透析合并THPT患者,随机分为对照组（骨化三醇和司维拉姆,60例）,观察组（三联疗法,60例）。比较两组全段甲状旁腺素（intact parathyroid hormone,iPTH）水平、心脏功能、血管钙化及生活质量。结果 与对照组相比,治疗后观察组患者血清iPTH水平、血管钙化评分和总不良反应率较低;心血管参数改善更优;生活质量评分和总有效率较高。结论 三联疗法降低血液透析合并THPT患者的iPTH水平,延缓血管钙化进展,疗效明显,且安全性良好。
Abstract
Objective To evaluate the efficacy of cinacalcet combined with calcitriol and sevelamer (triple therapy) in hemodialysis patients with tertiary hyperparathyroidism (THPT). Methods This retrospective study included 120 THPT patients treated at Xinjiang 474 Hospital (January 2021-July 2024). Patients were randomized into: control group (calcitriol+sevelamer, n=60) and observation group (triple therapy, n=60). Outcomes included intact parathyroid hormone (iPTH), cardiac function, vascular calcification, and quality of life. Results Compared with controls, the serum iPTH level, vascular calcification score and total adverse reaction rate were lower in the observation group after treatment. Cardiovascular parameters improved better; the quality of life score and total effective rate were higher. Conclusion Triple therapy effectively reduces iPTH, slows vascular calcification progression with favorable safety in hemodialysis patients with THPT.
关键词
西那卡塞 /
三发性甲状旁腺功能亢进 /
血液透析 /
全段甲状旁腺激素
Key words
cinacalcet /
tertiary hyperparathyroidism /
hemodialysis /
intact parathyroid hormone
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基金
乌鲁木齐市卫生健康委科技计划项目“西那卡塞治疗三发性甲状旁腺功能亢进的临床疗效及安全性研究”（202145）
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