鲑鱼降钙素对肾性骨病并继发性甲旁亢患者的作用观察

中国临床药理学与治疗学 ›› 2008, Vol. 13 ›› Issue (8): 938-941.

鲑鱼降钙素对肾性骨病并继发性甲旁亢患者的作用观察

梁玉环¹, 高鑫², 乔静²

¹山东省泰山慢性病医院肾内科,
² 解放军第八十八医院肾内科, 泰安271000, 山东

收稿日期:2008-07-04 修回日期:2008-08-30 出版日期:2008-08-26 发布日期:2020-10-12
作者简介:梁玉环, 女, 硕士研究生, 副主任医师, 研究方向:肾小球动脉硬化症及血液净化。Tel:0538-6232057　E-mail:yuhuanl@163.com

An effective observation of salmon calcitonin on patients with renal osteodystrophy and secondary hyperparathyroidism

LIANG Yu-huan¹, GAO Xin², QIAO Jing²

¹Urology Department, Taishan Chronic Disease Hospital,
² Urology Department, the 88th Hospital of PLA, Taian 271000, Shandong, China

Received:2008-07-04 Revised:2008-08-30 Online:2008-08-26 Published:2020-10-12

摘要/Abstract

摘要： 目的:观察鲑鱼降钙素皮下注射对肾性骨病并继发性甲旁亢患者的作用。方法:选择合并有继发性甲状旁腺机能亢进的65例肾性骨病患者为研究对象, 采用简单随机的方法分组, 治疗组给予鲑鱼降钙素治疗, 对照组给予活性维生素D治疗, 用药前和用药4、8、12周分别进行视觉模拟疼痛评分和血钙、血磷和血甲状旁腺素(PTH)检测, 并进行统计学分析。结果:治疗组入组33例,对照组入组32例, 应用鲑鱼降钙素后, 治疗组甲状旁腺素、血磷和血钙明显降低, 与对照组比较差异有统计学意义(P<0.05);患者骨关节疼痛等症状均有不同程度缓解, 与对照组比较差异有统计学意义(P<0.05);但已发生的转移性钙化等现象无变化。结论:鲑鱼降钙素治疗肾性骨病并继发性甲旁亢时, 可以缓解骨关节疼痛症状, 并能够有效降低高甲状旁腺素、高血磷和高血钙, 值得进一步观察和探讨。

关键词: 肾性骨病, 鲑鱼降钙素, 甲状旁腺素, 继发性甲旁亢

Abstract: AIM:To study the effect of salmon calcitonin (Miacalcic)in treatment of renal osteodystrophy and secondary hyperparathyroidism in patients undergoing long-term hemodialysis (HD) or hemodiafiltration (HDF).METHODS:A total of 65 patients with renal osteodystrophy and secondary hyperparathyroidism were randomly assigned to receive either Miacalcic or calcitriol.All patients were treated with HD or HDF.The visual analog scale management of pain (VAS)and levels of serum calcium and phosphorus, parathyroid hormone (PTH)were monitored during 0, 4, 8, 12 weeks of treatment.RESULTS:33 and 32 patients were randomly assigned to Miacalcic group and control group.In Miacalcic group, the levels of serum calcium, phosphorus and PTH were more effectively decreased than those of control group.At the same time, the symptoms of renal osteodystrophy, such as bone pain and joint dysfunction were more significantly improved than those of control group.There were significant difference between Miacalcic group and control group(P<0.05).But there were no contribution to occurrenced metastatic calcification.CONCLUSION:In treatment of renal osteodystrophy and secondary hyperparathyroidism, Miacalcic can alleviate bone pain symptom and reduce the high PTH, high serum phosphorus and high serum calcium effectively, is remarkably efficacious and worthiness of advanced exploration.

Key words: renal osteodystrophy, salmon calcitonin, parathyroid hormone, secondary hyperparathyroidism

中图分类号:

R453.9

梁玉环, 高鑫, 乔静. 鲑鱼降钙素对肾性骨病并继发性甲旁亢患者的作用观察[J]. 中国临床药理学与治疗学, 2008, 13(8): 938-941.

LIANG Yu-huan, GAO Xin, QIAO Jing. An effective observation of salmon calcitonin on patients with renal osteodystrophy and secondary hyperparathyroidism[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2008, 13(8): 938-941.

参考文献 11

[1]	王海燕, 王梅, 主译.慢性肾脏病骨代谢及其疾病的临床实践指南[美国NKF-F DOQI工作组] [M].北京:人民卫生出版社, 2003:303.
[2]	陈新谦, 金有豫, 汤光.新编药物学[M].16版.北京:人民卫生出版社, 2007:686.
[3]	Chesnut CH 3rd, Silverman S, Andriano K, et al.A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis :the prevent recurrence of osteoporotic fractures study.PROOF Study Group[J].Am J Med, 2000, 109(4):267-276.
[4]	Bonica JJ.The management of pain[M].2nd ed.Philadephia :Lea and Febiger, 1990:581.
[5]	Sherrard DJ, Hercs G, PeiY, et al.The spectrum of bone disease in end-stage renal failure-An evolving disorder[J]. Kidney Int, 1993, 43(2):436-442.
[6]	Gukal R, Nulph KD.The textbook of peritonal dialysis [M].Netherlands:Klower Academic Publishers, 1994: 529-553.
[7]	Carney SL, EpsteinMT.Effect of calcitonin on hemodialy-· 940· Chin J Clin Pharmacol Ther 2008 Aug;13(8)sis patients with hypercalcemia and renal osteodystrophy [J].Uremia Invest, 1984, 85(2):97-101.
[8]	于宗周.血液净化与矿物质代谢异常[M].武汉:湖北科学技术出版社, 1989:55-61.
[9]	Gozariu L, Manasia M, Patiu TM, et al.Calcitonin secretion in chronic renal patients treated with hemodialysis[J]. Endocrinology, 1981, 19(4):253-256.
[10]	Delmas PD, Ensrud KE, AdachiJD, et al.Efficacy of raloxifene on vertebral fracture risk reduction in postmenopausal women with osteoporosis:four-year results from a randomized clinical trial[J].J Clin Endocrinol Metab, 2002, 87(8):3609-3617.
[11]	Kitob C.Calcitonin therapy in dialysis patients[J]. Nephron, 1980, 26(4):206.