摘要
目的系统评价西那卡塞联合小剂量骨化三醇治疗维持性血液透析患者继发甲状旁腺功能亢进(secondaryhyperparathyroidism,SHPT)的疗效。方法利用计算机检索PubMed、万方、中国知网数据库中关于西那卡塞联合小剂量骨化三醇和西那卡塞治疗血液透析患者SHPT疗效比较的文献,检索时间从建库至2020年11月1日,采用RevMan 5.1软件进行Meta分析。结果最终有10篇文献纳入Meta分析,共计726例患者。Meta分析结果显示:与西那卡塞组相比,西那卡塞联合小剂量骨化三醇组降低iPTH[MD=-89.41,95%CI(-120.36,-58.46),P<0.00001]、升高血钙[MD=0.37,95%CI(0.28,0.46),P<0.00001]、降低血磷[MD=-0.24,95%CI(-0.33,-0.15),P<0.00001]、降低碱性磷酸酶[MD=-32.35,95%CI(-41.52,-23.18),P<0.00001]、缩小甲状旁腺体积[MD=-0.31,95%CI(-0.39,-0.23),P<0.00001]、降低不良反应发生率[OR=0.20,95%CI(0.09,0.44),P<0.0001]。结论西那卡塞联合小剂量骨化三醇治疗血液透析患者SHPT临床疗效优于西那卡塞组,不良反应发生率更低。
Objective To systematically evaluate the efficacy of cinacalcet combined with low-dose calcitriol in treating maintenance hemodialysis patients with secondary hyperparathyroidism.Methods We searched PubMed,Wanfang,and CNKI databases to collect clinical research results on comparing the efficacy of cinacalcet combined with low dose calcitriol and cinacalcet in the treatment of SHPT in hemodialysis patients.The search period was from establishing the database to November 1,2020.The Rev Man 5.1 software was used for meta-analysis.Results Finally,10 studies were included in the meta analysis,involving 726 patients.Meta-analysis results showed that:compared with the cinacalcet group,cinacalcet combined with low-dose calcitriol group decreased iPTH[MD=-89.41,95%CI(-120.36,-58.46),P<0.00001],increased serum calcium[MD=0.37,95%CI(0.28,0.46),P<0.00001],decreased serum phosphorus[MD=-0.24,95%CI(-0.33,-0.15),P<0.00001],decreased alkaline phosphatase[MD=-32.35,95%CI(-41.52,-23.18),P<0.00001],reduced the volume of parathyroid glands[MD=-0.31,95%CI(-0.39,-0.23),P<0.00001]and reduced the incidence of adverse reactions[OR=0.20,95%CI(0.09,0.44),P<0.0001].Conclusion The clinical efficacy of cinacalcet combined with low dose calcitriol in the treatment of SHPT is better than that in the cinacalcet group in hemodialysis patients,and the incidence of adverse reactions is lower.
作者
成进华
王敏
胡劲涛
吴扬
李华
尚伟锋
CHENG Jinhua;WANG Min;HU Jintao;WU Yang;LI Hua;SHANG Weifeng(Jianghan Hospital of Xiantao,Xiantao 433099,Hubei,China;Department of Nephrology,Wuhan Fourth Hospital,Puai Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430033,Hubei,China)
出处
《江汉大学学报（自然科学版）》
2022年第1期65-71,共7页
Journal of Jianghan University：Natural Science Edition
