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目的观察基层医院对慢性肾脏病(Chronic Kidney Disease,CKD)3期开始常规口服小剂量活性维生素D与未使用活性维生素D的患者,在进入透析治疗后发生肾性骨病的差异。方法将1 a来来自基层医院的CKD维持性透析治疗的42例患者按既往有无使用活性维生素D分为A、B两组:A组为CKD 3期开始常规口服小剂量活性维生素D组;B组为未使用活性维生素D组,观察两组患者在进入维持性透析治疗时血清钙、磷、甲状旁腺激素(iPTH)客观指标的差异。结果 A组较B组钙、磷、iPTH差异有统计学意义(P<0.05,P<0.01,P<0.001),且更为接近慢性肾脏病钙、磷、iPTH的治疗目标范围。结论基层医院虽不能常规查iPTH,但对CKD 3期开始常规口服小剂量活性维生素D对于慢性肾脏病肾性骨病有着积极的治疗意义,值得在基层医院推广应用。
Objective To observe the difference of renal osteodystrophy after primary hemodialysis in primary Hypochondria in patients with Chronic Kidney Disease (CKD) in Phase 3 after oral administration of small doses of active vitamin D and non-active vitamin D. Methods A total of 42 patients undergoing CKD maintenance dialysis from primary hospitals were divided into A and B groups on the basis of their past and absent active vitamin D for one year. Group A was started oral administration of low dose of active vitamin D at the third phase of CKD. Group B was inactive vitamin D group. The difference of objective indexes of serum calcium, phosphorus, and parathyroid hormone (iPTH) in two groups were observed when they entered maintenance dialysis. Results The difference of calcium, phosphorus and iPTH between group A and group B was statistically significant (P <0.05, P <0.01, P <0.001), and more close to the treatment target range of CK, P and iPTH. Conclusions Although the primary hospitals can not routinely survey iPTH, the routine oral administration of small doses of active vitamin D to CKD stage 3 has a positive therapeutic effect on chronic kidney disease with renal osteodystrophy and is worth popularizing and applying in primary hospitals.