关键词: 维持性血液透析, 磷结合剂, 血清总钙, 血磷, 钙磷乘积, 甲状旁腺激素

Abstract: 【Abstact】 objective To assess the effects and side effects of four kinds of phosphate binder on changes of serum phosphorate、serum total calcium、calcium-phosphorus product、intact parathyroid hormone in maintenance hemodialysis patients. Methods 43 patients with serum phosphorus > 1.78 mmol/L and non-use active vitamin D3 more than one week were randomly divided into 4 groups, group A includes twelve patients who taking calcium carbonate (300 mg, bid); Group B includes thirteen patients who taking lanthanum carbonate (500 mg, bid); groups C includes ten 10 people who taking sevelamer hydrochloride (800 mg, bid); groups D includes eight people who taking aluminum hydroxide (300 mg, tid); Group E includes nine patients who not taking any phosphate binder as control group. All of medicines were chewed at meals. Two weeks later, we compared the changes of serum phosphate、serum total calcium、calcium-phosphorus product、parathyroid hormone with themselves and different groups. The date was analyzed by the spss 13.0 software. Results (1) self-control before and after treatment, the serum phosphate reductions and serum iPTH reductions was statistically significant in all four groups; the serum calcium reductions was statistically significant in group B and group D; the serum calcium-phosphorus product reductions were statistically significant in group B,C,D.(2) compared with different groups on the serum phosphate reductions and serum iPTH reductions , B group, C group, D group were significant higher than group A (P < 0.01) , the group B,C,D were not statistical different; on the serum calcium-phosphorus product reductions , group B ,C, D were significant higher than group A (P < 0.01) , group D was significant higher than group B (P < 0.01), group B, C was not statistically different; on the serum total calcium reductions, group D was significantly higter than group B, C that was not statistically different (3) All the four groups were not statistically different on side effects. Conclusions All the four different kinds of phosphate binders have effects on serum phosphate and serum iPTH reductions using the above doses in the same time； calcium carbonate is weaker than others on serum phosphorus, calcium-phosphate product and iPTH reductions. Lanthanum carbonate and sevelamer hydrochloride have no significant difference on the contrast items; aluminum hydroxide is better than others on serum calcium and calcium-phosphate product reductions.

Key words: Maintenance hemodialysis, Phosphate binder, Serum phosphrate, Serum total calcium, Serum calcium-phosphorus product, Parathyroid hormone