中国临床药理学杂志2024，Vol.40Issue(18)：2665-2669,5.DOI:10.13699/j.cnki.1001-6821.2024.18.012
碳酸镧与碳酸钙治疗终末期肾病维持性血液透析患者的临床研究
Clinical trial of lanthanum carbonate and calcium carbonate in the treatment of maintenance hemodialysis patients with end-stage renal disease
摘要
Abstract
Objective To explore the differences in curative effect of lanthanum carbonate and calcium carbonate on hyperphosphatemia in patients with end-stage renal disease(ESRD)after maintenance hemodialysis(MHD).Methods Patients with hyperphosphatemia after MHD treatment of ESRD were divided into treatment group and control group.Treatment group was given lanthanum carbonate chewable tablet orally,250 mg each time,tid;the control group was given calcium carbonate chewable tablets orally,500 mg each time,bid.Both groups were treated continuously for 3 months.The clinical efficacy,calcium and phosphorus metabolism,vascular sclerosis indexes[brachial ankle pulse wave conduction velocity(baPWV),ankle brachial index(ABI),homocystine(Hcy)],serum renal function indexes[[32 microglobulin(β2-MG),serum creatinine(SCr),blood urea nitrogen(BUN)],serum inflammation indexes[hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],and the safety was evaluated.Results There were 104 cases in the treatment group and 96 cases in the control group.After treatment,the effective rate of the treatment group was 94.23％(98 cases/104 cases)higher than that of the control group 85.42％(82 cases/96 cases),and the difference was statistically significant(P＜0.05).After treatment,the serum phosphorus levels of treatment group and control group were(1.42±0.19)and(1.68±0.20)mmol·L-1,respectively;the serum calcium levels were(2.32±0.30)and(2.49±0.24)mmol·L-1,respectively;the product of calcium and phosphorus were(49.28±6.25)and(52.05±5.60)mg2·dL-2,respectively;the baPWV levels were(1 560.72±114.90)and(1 613.49±109.77)cm·s-1,respectively;ABI levels were 1.20±0.09 and 1.17±0.07,respectively;Hcy levels were(32.02±3.21)and(34.84±2.89)μmol·L-1,respectively.Compared with the control group,there were statistically significant differences in the above indexes in treatment groups(all P＜0.05).After treatment,there was no significant difference in levels of renal function indexes(β2-MG,SCr,BUN)and inflammatory indexes(hs-CRP,TNF-α,IL-6)between the two groups(all P＞0.05).The adverse drug reactions of the treatment group were mainly diarrhea and rash;and the adverse drug reactions of the control group were mainly diarrhea and hypercalcemia.The difference in incidence of adverse drug reactions between control group and treatment group was not statistically significant(2.88％vs 3.13％,P＞0.05).Conclusion Compared with calcium carbonate,improvement effect of lanthanum carbonate is better on phosphorus and calcium-phosphorus metabolism in MHD patients with ESRD and hyperphosphatemia,which can delay the progression of vascular sclerosis.关键词
碳酸镧咀嚼片/碳酸钙咀嚼片/维持性血液透析/高磷血症/钙磷代谢Key words
lanthanum carbonate chewable tablet/calcium carbonate chewable tablet/maintenance hemodialysis/hyperphosphatemia/calcium and phosphorus metabolism分类
医药卫生引用本文复制引用
马续祥,王菡,纵晓英,周玉叶,桑苗苗..碳酸镧与碳酸钙治疗终末期肾病维持性血液透析患者的临床研究[J].中国临床药理学杂志,2024,40(18):2665-2669,5.基金项目
蚌埠医学院厅级重点实验室开放课题资助项目(AHTT2022B004) （AHTT2022B004）
蚌埠市级科技创新指导类基金资助项目(20220140) （20220140）
蚌埠医学院校级质量工程校级教研(重点)基金资助项目(2022fyjyxm06) （重点）
