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目的探讨骨化三醇联合鲑鱼降钙素对维持性血液透析患者高转运性骨病的疗效。方法 28例维持性血液透析并发肾性骨病伴高血钙、高血磷、高甲状旁腺素(PTH)患者,均给予骨化三醇及鲑鱼降钙素注射液治疗,给予非含钙磷结合剂降磷治疗,并配合低钙透析,观察治疗前后血钙、磷及PTH水平变化情况。结果用药12周后,患者血钙、血磷、PTH均较用药前下降,差异有统计学意义(P<0.05)。伴有骨痛的12例患者骨痛均有不同程度缓解,2例伴有肩关节及肘关节畸形者未见加重。结论骨化三醇联合鲑鱼降钙素对维持性血液透析患者高转运骨病治疗安全有效,且不引起血钙增高。
Objective To investigate the effect of calcitriol combined with salmon calcitonin on high transport osteopathy in maintenance hemodialysis patients. Methods 28 patients with maintenance hemodialysis complicated with renal osteodystrophy accompanied by hypercalcemia, hyperphosphatemia and hyperparathyroid hormone (PTH) were given calcitriol and salmon calcitonin injection, Phosphorus binding agent to reduce phosphorus treatment, and with low calcium dialysis, observe the changes of blood calcium, phosphorus and PTH levels before and after treatment. Results After 12 weeks of treatment, the levels of serum calcium, phosphorus and PTH in patients were significantly lower than those before treatment (P <0.05). Bone pain associated with bone pain in 12 patients with varying degrees of relief, 2 patients with shoulder and elbow joint deformities were not worse. Conclusions Calcitriol combined with salmon calcitonin is safe and effective for the treatment of high-grade bone transport disease in maintenance hemodialysis patients, and does not cause elevated serum calcium.