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目的探讨骨化三醇冲击治疗对慢性肾功能衰竭腹膜透析继发甲状旁腺功能亢进症(SHPT)患者成纤维细胞生长因子23(FGF23)、全段甲状旁腺激素(i PTH)、钙、磷的影响。方法 56例慢性肾功能衰竭腹膜透析继发甲状旁腺功能亢进症患者分为i PTH≤500 ng/L和i PTH>500 ng/L两个大组,每组28例;每大组随机分为骨化三醇常规治疗组(常规组)和冲击组,各14例。比较两组FGF23、i PTH、钙、磷的变化情况。结果 i PTH≤500 ng/L组:治疗前,常规组与冲击组患者FGF23、i PTH、矫正钙、磷及钙磷乘积比较差异无统计学意义(P>0.05);治疗后,常规组和冲击组FGF23、i PTH均明显下降,矫正钙、钙磷乘积显著上升,与治疗前比较差异有统计学意义(P<0.05),治疗后两组间比较差异无统计学意义(P>0.05)。i PTH>500 ng/L组:治疗后,常规组FGF23、i PTH明显下降(P<0.05),矫正钙、血磷、钙磷乘积与治疗前比较差异无统计学意义(P>0.05),冲击组FGF23、i PTH明显下降,矫正钙、钙磷乘积明显升高,与常规组治疗后比较差异有统计学意义(P<0.05)。结论骨化三醇冲击治疗有助于降低慢性肾功能衰竭腹膜透析继发甲状旁腺功能亢进症患者FGF23、i PTH水平,促进钙、磷代谢正常,改善患者预后。
Objective To investigate the effects of calcitriol shock therapy on the expression of fibroblast growth factor 23 (FGF23), total parathyroid hormone (i PTH), calcium, calcium in patients with chronic renal failure and peritoneal dialysis secondary hyperparathyroidism (SHPT) The impact of phosphorus. Methods 56 patients with chronic renal failure peritoneal dialysis secondary hyperparathyroidism were divided into two groups: i PTH≤500 ng / L and i PTH> 500 ng / L, with 28 cases in each group. Each group was randomized For calcitriol conventional treatment group (conventional group) and the impact group, 14 cases each. The changes of FGF23, i PTH, calcium and phosphorus in the two groups were compared. Results Before treatment, there was no significant difference in the product of FGF23, i PTH, corrected calcium, phosphorus and calcium between the conventional group and the impact group before treatment (P> 0.05). After treatment, (P <0.05). There was no significant difference between the two groups after treatment (P> 0.05), but there was no significant difference between the two groups (P> 0.05) . i PTH> 500 ng / L group: After treatment, FGF23 and i PTH decreased significantly in the conventional group (P <0.05), and there was no significant difference between the corrected calcium, phosphorus, Impact group FGF23, i PTH decreased significantly, correction of calcium, calcium and phosphorus products increased significantly, compared with the conventional group after treatment was statistically significant (P <0.05). Conclusion Calcitriol shock therapy can reduce FGF23 and i PTH levels in patients with chronic hyperparathyroidism due to peritoneal dialysis of chronic renal failure, promote normal calcium and phosphorus metabolism, and improve prognosis.