骨化三醇联合西那卡塞对继发性甲状旁腺功能亢进患者血钙血磷iPTH骨质疏松和心脏瓣膜钙化的影响

doi:10.3969/j.issn.1006-6233.2019.07.004

Abstract
Figure/Table
References
Related Citation (15)

Download: PDF (1263 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To analyze the effects of calcitriol combined with cinacalcet on serum calcium, phosphorus, intact parathyroid hormone(iPTH), osteoporosis and cardiac valve calcification in patients with secondary hyperparathyroidism. Methods: The clinical data of 60 patients with secondary hyperparathyroidism who underwent maintenance hemodialysis were collected as a retrospective study. According to the different treatment methods, they were divided into group A (12 cases), group B (30 cases), and group C (18 cases). The differences of iPTH, blood calcium, blood phosphorus, heart valve calcification and osteoporosis were compared between the two groups before and after treatment. Results: After treatment, the serum calcium concentration in group A decreased significantly (P<0.05), while that in group B increased significantly (P<0.05), while that in group C did not change significantly (P>0.05); compared with before treatment, the serum phosphorus concentration in group A and C decreased significantly (P<0.05), while that in group B did not change significantly (P>0.05); and compared with before treatment, the concentration of iPTH in group A, B and C decreased significantly after treatment. After treatment, the level in group C was significantly better than that in other two groups (P<0.05). Compared with before treatment, there was no significant change in the degree of cardiac valve calcification in group A and B after treatment (P>0.05), while the degree of cardiac valve calcification in group C was significantly reduced after treatment (P<0.05). After treatment, the incidence of osteoporosis in group A and B was not significantly different from that before treatment (P>0.05); compared with before treatment, the incidence of osteoporosis in group C was significantly lower after treatment (P<0.05). Conclusion: Calcitriol combined with cinacalcet can promote the maintenance of serum calcium and phosphorus concentration in normal range and control the level of iPTH in secondary hyperparathyroidism patients. It can also effectively reduce the degree of cardiac valve calcification and the occurrence of osteoporosis. The therapeutic effect of the combined use of calcitriol and cinacalcet is better than that of single usage, so it is worthy of clinical application.

Key words： Secondary hyperparathyroidism Hemodialysis Calcitriol Cinacalcet Blood calcium Blood phosphorus

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	WANG Yi

Cite this article:

WANG Yi. Effects of Calcitriol combined with Cinacalcet on Serum Calcium Phosphorus iPTH Osteoporosis and Cardiac Valve Calcification in Patients with Secondary Hyperparathyroidism[J]. HeBei Med, 2019, 25(7): 1073-1077.

URL:

http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2019.07.004 OR http://www.hbyxzzs.cn/EN/Y2019/V25/I7/1073

[1] 聂晟,谢迪,李璐,等.血液透析患者阿司匹林出血事件的meta分析[J].郑州大学学报(医学版),2013,48(1):35~38.
[2] Urena Torres PA, Bover J, Cohen-Solal M.Etelcalcetide: injectable calcimimetic for the treatment of secondary hyperparathyroidism in hemodialysis-dependent patients[J].Drugs Today (Barc),2017,53(9):489~500.
[3] Rroji M, Spasovski G.Calcimimetics versus parathyroidectomy: What is preferable[J].Int Urol Nephrol,2018,50(7):1271~1275.
[4] Friedl C, Zitt E.Role of etelcalcetide in the management of secondary hyperparathyroidism in hemodialysis patients: a review on current data and place in therapy[J].Drug Des Devel Ther,2018,12(1):1589~1598.
[5] 王莉,李贵森,刘志红,等.中华医学会肾脏病学分会《慢性肾脏病矿物质和骨异常诊治指导》[J].肾脏病与透析肾移植杂志,2013,22(6):554~559.
[6] Brunerova L, Ronova P, Veresova J, et al.Osteoporosis and impaired trabecular bone score in hemodialysis patients[J].Kidney Blood Press Res,2016,41(3):345~354.
[7] Shigematsu T, Fukagawa M, Yokoyama K, et al.Long-term effects of etelcalcetide as intravenous calcimimetic therapy in hemodialysis patients with secondary hyperparathyroidism[J].Clin Exp Nephrol,2018,22(2):426~436.
[8] Wan J, Li W, Zhong Y.Parathyroidectomy decreases serum intact parathyroid hormone and calcium levels and prolongs overall survival in elderly hemodialysis patients with severe secondary hyperparathyroidism[J].Clin Lab Anal,2018,28 (1):e22696.
[9] 赵亚娟,黄兰,辛立升,等.骨化三醇冲击治疗对血液透析继发性甲状旁腺功能亢进症及FGF23的作用[J].河北医学,2016,22(11):1861~1863.
[10] Hamano N, Komaba H, Fukagawa M.Etelcalcetide for the treatment of secondary hyperparathyroidism[J].Expert Opin Pharmacother,2017,18(5):529~534.
[11] Sun X, Huang L, Wu J, et al.Novel homozygous inactivating mutation of the calcium-sensing receptor gene in neonatal severe hyperparathyroidism responding to cinacalcet therapy: A case report and literature review[J].Medicine (Baltimore),2018,97(45):e13128.