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【目的】探讨维生素 D、非含钙的磷结合剂与含钙的磷结合剂对慢性肾脏疾病患者血管钙化进展的影响。【方法】随机选取本院自2010年1月至2014年12月收治的78例慢性肾脏病患者作为研究对象,按就诊顺序编号,参照随机数字表法分为 A、B 两组,每组39例,均采用维生素 D 治疗,A 组在此基础上加用非含钙的磷结合剂碳酸镧治疗,B组则采用常规含钙的磷结合剂醋酸钙治疗,比较治疗前后两组血钙、血磷、钙磷乘积、全段甲状旁腺激素(iPTH)水平的变化,比较两组维生素 D、钙磷结合剂使用情况,配合影像学检查评估患者冠脉钙化积分(CACs)的变化,统计治疗期间不良事件发生率。【结果】①治疗后,两组血磷、钙磷乘积、iPTH 水平均较治疗前明显降低,但两组间相比较差异无显著性(P >0.05),A 组血钙水平降低至(2.24±0.17)mmol/L,降低幅度高于 B 组,两组相比较差异有显著性(P <0.05)；②A 组磷结合剂摄入量为(1719.21±410.22)mg/d,明显低于 B 组的(4913.34±1332.26)mg/d,两组相比较差异有显著性(P <0.05)；③B 组中重度钙化分别占20.51%、10.26%,均高于 A 组(P <0.05)；④A 组不良事件发生率为10.26%,明显低于 B 组的48.72%,两组相比较差异有显著性(P 0.05).Blood calcium level in group A was reduced to(2.24±0.17)mmol/L and the decreased amplitude was higher than that in Group B (P <0.05);② The intake of phosphorus binder of Group A [(1719.21±410.22)mg/d]was signifi-cantly lower than that of Group B [(4913.34±1332.26)mg/d](P <0.05).③ Moderate and severe calcification in Group B accounted for 20.51% and 10.26%,respectively,which were higher than the amounts they accounted for in Group A (P <0.05).④ The incidence of adverse events in Group A (10.26%)was significantly lower than that in Group B (48.72%)(P<0.05).[Conclusion]In the treatment and prevention of vascular calcification in patients with chronic kidney disease,adopting vitamin D combined with non-calcium phosphate binders (lanthanum carbonate)intervention results in a good effect in the blood calcium control,and the incidence of adverse events is low.It can slow down the progression of vascular calcification.