Lind L, Wengle B, Wide L, Wrege U, Ljunghall S
Department of Internal Medicine, Gävle County Hospital, Uppsala, Sweden.
Nephron. 1988;48(4):296-9. doi: 10.1159/000184946.
Seven patients on chronic hemodialysis were given alphacalcidol (1 alpha-OH-vitamin D3) intravenously in a pilot study during 3 months. Before treatment all patients had serum calcium values within the normal range, but elevated levels of parathyroid hormone (PTH). When serum calcium was raised above the normal range by treatment with alphacalcidol, all patients displayed marked suppression of PTH levels with a mean reduction of 40 +/- 20% (SD; p less than 0.01). When the dose of alphacalcidol was reduced so that the serum calcium values were kept at the upper limit of the normal range, a partial return towards pretreatment values of PTH was seen but the levels were still lowered (p less than 0.05). Thus, intravenous administration of the vitamin D compound appeared to be useful for the management of secondary hyperparathyroidism in patients on dialysis. A direct effect of alphacalcidol on the parathyroid glands could, however, not be distinguished from the calcemic action.
在一项为期3个月的初步研究中，对7例慢性血液透析患者静脉注射阿法骨化醇（1α-羟基维生素D3）。治疗前，所有患者的血清钙值均在正常范围内，但甲状旁腺激素（PTH）水平升高。在用阿法骨化醇治疗使血清钙升高至正常范围以上后，所有患者的PTH水平均显著降低，平均降低40±20%（标准差；p<0.01）。当阿法骨化醇剂量减少以使血清钙值维持在正常范围上限时，PTH水平部分恢复至治疗前水平，但仍低于治疗前（p<0.05）。因此，静脉注射这种维生素D化合物似乎对治疗透析患者的继发性甲状旁腺功能亢进有效。然而，阿法骨化醇对甲状旁腺的直接作用与血钙作用无法区分。
