碳酸镧治疗维持性血液透析患者高磷血症的疗效
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摘要：目的 探讨碳酸镧治疗维持性血液透析患者高磷血症的临床疗效。方法 选取2017年1月～2018年12月我院治疗发生高磷血症的72例维持性血液透析患者，采用随机数字表法分为观察组和对照组，每组36例。对照组给予碳酸钙D3咀嚼片治疗，观察组给予采取碳酸镧治疗，比较两组治疗前后血磷、全段甲状旁腺激素及不良反应发生率。结果 治疗后1、2、3个月后，两组血磷、全段甲状旁腺激素均较治疗前下降，且观察组低于对照组，差异有统计学意义（P<0.05）。两组恶心/呕吐、腹泻、便秘发生率比较，差异无统计学意义（P>0.05）。结论 碳酸镧治疗维持性血液透析患者高磷血症疗效确切，能够有效降低患者血磷、全段甲状旁腺激素，且安全性较高。
关键词：维持性血液透析;高磷血症;碳酸镧
中图分类号：R459.5 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.24.053
文章编号：1006-1959（2019）24-0148-03
Effect of Lanthanum Carbonate on Hyperphosphatemia in Patients with Maintenance Hemodialysis
QIU Bao-zhen
（Department of Nephrology，Meizhou People's Hospital，Meizhou 514031，Guangdong，China）
Abstract：Objective To investigate the clinical effect of lanthanum carbonate on hyperphosphatemia in patients with maintenance hemodialysis. Methods A total of 72 maintenance hemodialysis patients with hyperphosphatemia who were treated in our hospital from January 2017 to December 2018 were selected and divided into observation group and control group by random number table method， with 36 cases in each group. The control group was treated with calcium carbonate D3 chewable tablets， and the observation group was treated with lanthanum carbonate. The incidences of blood phosphorus， whole parathyroid hormone and adverse reactions were compared between the two groups before and after treatment. Results After 1， 2， and 3 months after treatment， blood phosphorus and total parathyroid hormone in the two groups were lower than before treatment. The blood phosphorus and full parathyroid hormone in the observation group were lower than those in the control group，the difference was statistically significant （P<0.05）. There was no significant difference in the incidence of nausea / vomiting， diarrhea， and constipation between the two groups（P>0.05）. Conclusion Lanthanum carbonate is effective in the treatment of hyperphosphatemia in patients with maintenance hemodialysis. It can effectively reduce the blood phosphorus and the whole parathyroid hormone of patients， and it has high safety.
Key words：Maintenance hemodialysis;Hyperphosphatemia;Lanthanum carbonate
維持性血液透析（maintenance hemodialysis）是一种利用血液透析或腹膜透析等方式延长患者生存周期、改善其生存质量的过度方法，已成为肾脏病患者主流治疗手段[1]。随着老龄化社会的来临，慢性肾脏病发病率也呈逐年升高趋势，维持性血液透析的应用频率亦随之提高[2]。然而，长期接受维持性血液透析治疗的患者容易发生多种并发症，其中高磷血症最为常见[3]，严重影响患者生活及生存质量。因此，控制高磷血症对改善维持性血液透析患者生活质量和预后具有重要意义。目前，治疗高磷血症的方法主要有控制饮食中磷的摄入和口服磷结合剂。传统磷结合剂主要为含铝和含钙的磷结合剂，长期应用后可能导致高铝血症和高钙血症。碳酸镧是新型不含铝和钙的磷结合剂，有研究表明[4]，碳酸镧具有良好的降低血磷水平的作用。本研究主要探讨碳酸镧治疗维持性血液透析患者高磷血症的临床疗效，现报道如下。
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