碳酸镧与醋酸钙治疗维持性透析患者高磷血症的比较研究

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Abstract Objective: To explore the efficacy and the effects on vascular calcification between the new type phosphate binder lanthanum carbonate and traditional phosphate binder calcium acetate for hyperphosphatemia in patients undergoing maintenance dialysis. Methods: 80 eligible patients were randomly divided into lanthanum carbonate group and calcium acetate group according to random number table. X-ray measurement was used to evaluate the degree of vascular calcification. Serum phosphorus, calcium, calcium-phosphorus product, and PTH were detected to compare the short-term and long-term efficacy and effects on vascular calcification between the two groups. Results: Serum phosphorus of both two groups were decreased in the short term. In the first two weeks of treatment, serum phosphorus and calcium-phosphorus product between two groups were no significant difference. Treatment for 4 weeks, the levels of lanthanum carbonate group serum phosphorus were decreased significantly compared with the calcium acetate group (P<0.01) and the levels of calcium-phosphorus product were also reduced obviously (P<0.01). After 1 year maintenance treatment, the levels of serum phosphorus and PTH had no obvious difference, both of the two medicine can decrease the levels of serum phosphorus efficiently. However, the calcium-phosphorus product in lanthanum carbonate group was much lower than in calcium acetate group (P<0.01); Serum phosphorus of peritoneal dialysis patients in lanthanum carbonate group was decreased more obvious than hemodialysis patients (P<0.05). Compared the vascular calcification, 12 cases of the lanthanum carbonate group appeared slight calcification, moderately severe calcification 3 case, hypercalcemia 0 case, the rate of adverse effects was 37.5%; 14 cases of calcium acetate group appeared mild vascular calcification, moderately severe vascular calcification in 8 cases, 8 hypercalcemia, the rate of adverse effects was 75.0%. The difference was statistically significant by x2 test (P<0.01). Conclusion: Lanthanum carbonate is effective in the treatment of hyperphosphatemia of dialysis patients with better short-term efficacy, fewer hypercalcemia and lower calcium-phosphorus product compared to calcium acetate. And it has little influence on vascular calcification.

Key words： lanthanum carbonate calcium acetate hyperphosphatemia vascular calcification

Received: 02 March 2015

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	SHAO Ningjun1
	WANG Dexuan2
	ZHUANG Jieqiu2
	PAN Min1
	PAN Lulu1
	ZHOU Zhihong1
	FEI Jinping3
	GAO Yiyi4
	CAI Hui1
	5.

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2015/V45/I7/484

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