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目的 以口服活性维生素 D3( 罗钙全) 冲击治疗为对照,观察和比较静脉注射活性维生素 D3( 溉纯) 治疗尿毒症性甲状旁腺机能亢进( 甲旁亢) 的有效性及安全性。方法 根据血浆完整甲状旁腺激素(i P T H) 浓度,64 例患者分为轻、中、度重度甲旁亢组,3 组再随机分为对照组和溉纯治疗组,分别给予2μg 、3μg 、4μg 罗钙全口服或溉纯静脉注射,观察治疗前后 P T H、 A K P、钙和磷的变化。结果 治疗前对照组和溉纯组间的 P T H 水平差异无显著性;治疗后轻、中度甲旁亢组i P T H 显著下降,两组下降程度差异无显著性;但对重度甲旁亢,溉纯抑制 P T H 分泌优于口服罗钙全组( P<0 .05) ,而高血钙副作用则低于后者。结论 溉纯治疗尿毒症继发性甲旁亢安全、有效,副作用小。与口服罗钙全冲击治疗比较,静脉注射溉纯更适于重度甲旁亢的治疗。
Objective To compare the efficacy and safety of intravenous injection of active vitamin D3 (irrigating pure) in the treatment of uremic hyperparathyroidism (hyperparathyroidism). Methods According to the concentration of plasma total parathyroid hormone (i PTH), 64 patients were divided into mild, moderate and severe hyperparathyroidism group. The three groups were randomly divided into control group and pure irrigation group, and received 2 μg, 3μg, 4μg Luo calcium total oral or irrigation pure intravenous injection, before and after treatment P T H, A K P, calcium and phosphorus changes. Results Before treatment, there was no significant difference in PTH levels between the control group and the pure irrigation group. The levels of iPTH in the mild and moderate hyperparathyroidism groups were significantly decreased after treatment, but there was no significant difference between the two groups. However, Hyperparathyroidism, pure irrigation inhibition of P T H secretion is superior to the oral Luo calcium group (P <0 .05), while the side effects of hypercalcemia is lower than the latter. Conclusion Pure irrigation treatment of uremia secondary hyperparathyroidism safe, effective, side effects. Compared with oral Luo calcium full impact treatment, intravenous injection of pure water is more suitable for the treatment of severe hyperparathyroidism.