摘要
目的回顾性分析碳酸司维拉姆和碳酸镧治疗维持性血液透析(Maintenance hemodialysis,MHD)患者高磷血症临床疗效比较。方法回顾性收集2019年1月~12月在天津市海河医院维持性血液透析伴有高磷血症患者95例,分为碳酸镧组(67例)、碳酸司维拉姆组(28例);两组患者均连续治疗12个月,两组患者均于治疗前后分别进行疗效观察,观察两组患者治疗前后血钙、血磷、血清全段甲状旁腺激素(intact parathyroid hormone,i PTH)、碱性磷酸酶(Alkaline phosphatase,ALP)、血红蛋白、低密度脂蛋白、甘油三酯、糖化血红蛋白,并记录用药期间心血管事件、骨折、钙化防御以及药物不良反应。结果碳酸镧组治疗后血磷较前降低,血红蛋白较前改善升高,差异有统计学意义(P<0.05);碳酸司维拉姆组治疗后血磷、低密度脂蛋白、甘油三酯、糖化血红蛋白较前降低,血红蛋白较前改善升高,差异有统计学意义(P<0.05);碳酸司维拉姆组消化道不良反应发生率低于碳酸镧组,差别有统计学意义(P<0.05)。结论两组治疗维持性血液透析的高磷血症患者效果明显,降磷疗效相当;碳酸司维拉姆可以改善体内脂质以及糖基化代谢产物代谢,降低低密度脂蛋白以及甘油三酯、糖化血红蛋白,减少透析患者住院次数,且胃肠道不良反应发生率低于碳酸镧组。
Objective Retrospective analysis of sevelamer carbonate and lanthanum carbonate in the treatment of maintenance hemodialysis(MHD)patients with hyperphosphatemia clinical curative effect comparison.Methods We collected in January 2019~December in the Haihe hospital 95 patients of maintenance hemodialysis with hyperphosphatemia.Divided into lanthanum carbonate group(67 cases),sevelamer carbonate group(28 cases).Two groups of patients observed in 1 month,12 months after treatment,respectively,the curative effect,observed two groups of patients before and after treatment the blood calcium and blood phosphorus and serum segment parathyroid excitation,ALP,hemoglobin,low density lipoprotein cholesterol,triglycerides,glycosylated hemoglobin,and recorded during cardiovascular events,fracture,calcified defense and adverse drug reactions.Results Lanthanum carbonate group after treatment the blood phosphorus reduced from the previous,hemoglobin improved earlier increases,the difference was statistically significant(P<0.05).Two groups of effective phosphorus treatment,as well as the total curative effect were markedly improved no significant statistical difference(P>0.05).Sevelamer carbonate group number of times hospitalizes and incidence of gastrointestinal adverse reactions reduced than lanthanum carbonate group,the difference was statistically significant(P<0.05).Conclusion Two groups of treatment of maintenance hemodialysis patients with hyperphosphatemia effect is obvious,and two groups of curative effect is similar.Sevelamer carbonate can improve lipid metabolism and glycosylation metabolites in the body,lower LDL and triglycerides,and glycosylated hemoglobin.Secondly it can reduce the number of dialysis patients in the hospital,and lower incidence of gastrointestinal side effects than lanthanum carbonate group.Both in the incidence of cardioascular events,fracture,the incidence of calcification defense have no significant statistical differences.
作者
刘文静
张悦凤
LIU Wen-jing;ZHANG Yue-feng(Tianjin Haihe Hospital,Tianjin 300350,China)
出处
《中国处方药》
2020年第9期4-7,共4页
Journal of China Prescription Drug
关键词
维持性血液透析
高磷血症
碳酸司维拉姆
碳酸镧
Maintenance hemodialysis
Hyperphosphatemia
Sevelamer Carbonate
Lanthanum carbonate
