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目的：观察碳酸司维拉姆在维持性血液透析（MHD）患者联合使用骨化三醇胶丸（罗盖全）冲击治疗继发性甲状旁腺功能亢进时对血清钙、磷水平的影响。方法维持性血液透析患者30例，甲状旁腺素600～900 pg/ml、血磷＞1.78 mmol/L、血钙（2.14±0.32） mmol/L，所有患者均行碳酸氢盐透析治疗，透析3次/w，4 h/次，透析液钙离子浓度为1.5 mmol/L；将其分为两组，第1组为司维拉姆组，共16例患者，给予口服司维拉姆800 mg，3次/d，联合骨化三醇2.0μg，冲击治疗2次/w；第2组为碳酸钙组，共14例患者，给以口服碳酸钙D 600 mg，1次/d，联合骨化三醇2.0μg，冲击治疗2次/w，监测两组患者血钙、血磷及iPTH水平的变化。结果司维拉姆组2个月后血磷及iPTH较治疗前明显下降，血钙较治疗前无明显变化，血磷较碳酸钙组有明显下降，差异有统计学意义（P＜0.05）。结论司维拉姆能有效改善MHD患者联合骨化三醇冲击治疗继发性甲状旁腺功能亢进症时的高磷血症，而对血钙无明显影响。“,”Objective To investigate the effect of sevelamer hydrochloride (renagel)on serum calcium and serum phosphorus in maintenance hemodialysis(MHD)patients with secondary hyperparathyroidism(SHPT) treated by calcitriol pulse theraphy.Methods Thirty MHD patients,with intact parathormone(iPTH)levels of 600~900pg/mL,were treated with calcitriol(2.0 g,biw)pulse therapy.Sixteen of the patients(the study group)were treated with oral renagel (800 mg/d,rid),and fourteen of the patients (the control group)were treated with calcium carbonate 600 mg/d .Serum phosphate, calcium and iPTH were examined within 2 months of therapy.Results Serium phosphate and iPTH levels 2 months after treatment in the study group were significantly lower than those before treatment,but the serum calcium levels had no significant change.The levels of serum phosphate in the study group were significantly lower than those in the control group (P<0.05).Conclusion Sevelamer serves as a uscful approach for improving the hyperphosphatemia in MHD patients with SHPT using calcitriol pulse therapy,and serum calcium levels had no significant change.