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碳酸镧治疗尿毒症维持性血液透析患者高磷血症的临床观察
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| 篇名： | 碳酸镧治疗尿毒症维持性血液透析患者高磷血症的临床观察 |
| TITLE： | |
| 摘要： | 目的：观察碳酸镧治疗尿毒症维持性血液透析患者高磷血症的临床疗效及安全性。方法：选取2012年1月－2016 年12月第三军医大学新桥医院和重庆市巴南区中医院的尿毒症维持性血液透析并发高磷血症患者142例，均给予嚼服碳酸镧咀嚼片治疗，起始剂量： 血磷为1.78～2.26 mmol/L时，250 mg，tid；血磷＞2.26 mmol/L时，500 mg，tid。在治疗过程中，根据患者血磷水平调整药物剂量。治疗1、2、3个月后，检测患者血磷、血钙、白蛋白、甲状旁腺激素（PTH）和碱性磷酸酶水平，计算校正血钙及钙磷乘积，并观察不良反应。结果：治疗1、2、3个月后，所有患者血磷、钙磷乘积水平均较治疗前显著下降，差异有统计学意义（P＜0.05）；治疗3个月后，血钙校正浓度较治疗前显著减低，差异有统计学意义（P＜0.05）；治疗前后，患者血浆白蛋白、碱性磷酸酶、PTH水平比较，差异无统计学意义（P＞0.05）。患者总有效率为93.7％。有19例患者出现轻微不良反应。结论：碳酸镧治疗尿毒症维持性血液透析患者高磷血症具有较高的临床有效率，能明显降低患者血磷和钙磷乘积，且安全性较好。 |
| ABSTRACT： | OBJECTIVE： To observe clinical efficacy and safety of lanthanum carbonate in the treatment of hyperphosphatemia in uremic patients underwent maintenance hemodialysis. METHODS： A total of 142 uremic patients with hyperphosphatemia underwent maintenance hemodialysis were selected from Xinqiao Hospital of Third Military Medical University and Chongqing Banan District Hospital of TCM during Jan. 2012-Dec. 2016. They were given Lanthanum carbonate chewable tablets with initial dose of 250 mg， tid， when serum phosphate level ranged 1.78-2.26 mmol/L or with initial dose of 500 mg， tid， when serum phosphate level was ＞2.26 mmol/L. Drug dosage was adjusted according the level of serum phosphate during treatment. After 1， 2， 3 months of treatment， the levels of serum phosphate， serum calcium， albumin， parathyroid hormone （PTH） and alkaline phosphatase were detected and the corrected product of serum calcium and calcium phosphorus was calculated. The occurrence of ADR was observed. RESULTS： After 1， 2， 3 months of treatment， the levels of serum phosphate and the product of serum calcium and calcium phosphorus were all decreased significantly compared to before trreatment， with statistical significance （P＜0.05）. After 3 months of treatment， the level of corrected serum calcium was decreased significantly compared to before treatment， with statistical significance （P＜0.05）. There was no statistical significance in the levels of plasma albumin， calcium phosphorus or PTH before and after treatment （P＞0.05）. Total response rate was 93.7％. There were 19 cases of patients with mild adverse reactions. CONCLUSIONS： Lanthanum carbonate in the treatment of hyperphosphatemia in uremic patients underwent maintenance hemodialysis shows good clinical response rate， can significantly reduce the levels of serum phosphate and the product of serum calcium and calcium phosphorus with good safety. |
| 期刊： | 2017年第28卷第20期 |
| 作者： | 江艳，黄珍伦，聂凌 |
| AUTHORS： | JIANG Yan，HUANG Zhenlun，NIE Ling |
| 关键字： | 碳酸镧；尿毒症；高磷血症；维持性血液透析 |
| KEYWORDS： | Lanthanum carbonate； Uremic； Hyperphosphatemia； Maintenance hemodialysis |
| 阅读数： | 408 次 |
| 本月下载数： | 2 次 |
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