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[1,25-二羟维生素D3治疗尿毒症性骨营养不良时各种生化参数的变化过程及意义]

[Course and significance of various biochemical parameters in 1,25-dihydroxyvitamin D3 therapy of uremic osteodystrophy].

作者信息

Giachino G, Giacchino F, Basolo B, Giraudo G, Boero R, Bancale E, Nigra M, Garetto A, Jeantet A, Piccoli G

出版信息

Arch Sci Med (Torino). 1983 Jul-Sep;140(3):259-66.

PMID:6689545
Abstract

Thirty-seven osteodystrophic and chronically haemodialyzed patients have been treated for 1-22 months by means of 1,25(OH)2D3. Under treatment a marked improvement of symptomatology and radiographic findings has been observed in the majority of cases; from the haematochemical viewpoint a rise of calcemia and phosphoremia, a fall in alkaline phosphatase and a variable course of PTH have been observed. Several episodes of asymptomatic hypercalcemia ceased with posology reduction; only 3 cases needed stopping the treatment for this reason, one of them definitively; 12/37 cases needed hypophosphoric diets and increase in oral aluminium hydroxide doses to control hyperphosphoremia. The Authors conclude that, to achieve a correct management of a 1,25(OH)2D3 therapy for renal osteodystrophy, is mandatory a strict and accurate biochemical control: in this way is possible to obtain an effective modulation of the posology avoiding the appearance of side-effects as hypercalcemia and ectopic calcifications.

摘要

37例骨营养不良且长期接受血液透析的患者接受了1,25(OH)₂D₃治疗,疗程为1至22个月。治疗期间,多数病例的症状及影像学表现有显著改善;从血液生化角度看,血钙和血磷升高,碱性磷酸酶降低,甲状旁腺激素(PTH)变化不一。几例无症状高钙血症发作通过减少剂量得以缓解;仅3例因此需要停止治疗,其中1例为永久性停药;37例中有12例需要低磷饮食并增加口服氢氧化铝剂量以控制高磷血症。作者得出结论,为正确管理肾性骨营养不良的1,25(OH)₂D₃治疗,严格准确的生化监测必不可少:通过这种方式,可有效调整剂量,避免出现高钙血症和异位钙化等副作用。

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