目的 考察帕立骨化醇注射液联合碳酸司维拉姆片治疗维持性血透继发性甲状旁腺功能亢进症的临床疗效。方法 选取2020年1月—2022年12月上海交通大学医学院附属新华医院收治的120例维持性血透继发性甲状旁腺功能亢进症患者作为研究对象，根据随机数字表法将所有患者分为对照组和治疗组，每组各60例。对照组餐中口服碳酸司维拉姆片，0.8 g/次，3次/d；在血液透析结束后口服骨化三醇软胶囊，3次/周。治疗组餐中口服碳酸司维拉姆片，0.8 g/次，3次/d；在血液透析结束后静脉注射帕立骨化醇注射液，1 mL/d。两组患者持续给药8周。观察治疗后临床疗效，比较两组甲状旁腺体积、血清指标、炎症因子。结果 治疗后，治疗组达标率86.67%，高于对照组患者的68.33%（P＜0.05）。治疗后，两组甲状旁腺体积均低于治疗前（P＜0.05），且治疗组患者甲状旁腺体积小于对照组（P＜0.05）。治疗后，两组血清血磷（P）、全段甲状旁腺素（iPTH）、碱性磷酸酶（AKP）水平均降低，血钙（Ca）水平升高（P＜0.05），且治疗组患者的血清P、iPTH、AKP水平低于对照组，血清Ca水平高于对照组（P＜0.05）。治疗后，两组患者血清白细胞介素-4（IL-4）、C反应性蛋白（CRP）水平均显著降低，血清γ干扰素（IFN-γ）水平显著升高（P＜0.05），且治疗组患者的血清IL-4、CRP水平均低于对照组，血清IFN-γ水平高于对照组（P＜0.05）。结论 帕立骨化醇注射液联合碳酸司维拉姆片治疗维持性血透继发性甲状旁腺功能亢进症患者疗效确切，能够减小患者甲状旁腺体积，调节体内钙磷代谢等血清因子水平，降低体内炎症因子水平。

Objective To investigate the effect of Paricalcitol Injection combined with Sevelamer Carbonate Tablets in treatment of hyperparathyroidism secondary to maintenance hemodialysis. Methods Patients (120 cases) with hyperparathyroidism secondary to maintenance hemodialysis in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2020 to December 2022 were divided into control and treatment groups according to the random number table method, and each group had 60 cases. Patients in the control group were po administered with Sevelamer Carbonate Tablets during meals, 0.8 g/time, three times daily. And after hemodialysis, patients in the control group were po administered with Calcitriol Soft Capsules, three times weekly. Patients in the treatment group were po administered with Sevelamer Carbonate Tablets during meals, 0.8 g/time, three times daily. And after hemodialysis, patients in the treatment group were iv administered with Paricalcitol Injection, 1 mL/d. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacies were evaluated, and the parathyroid volume, serum indicators, and inflammatory factors in two groups were compared. Results After treatment, the compliance rate of the treatment group was 86.67%, which was higher than 68.33% of the control group patients (P < 0.05). After treatment, the thyroid volume of two groups was smaller than before treatment (P< 0.05), and the thyroid volume in the treatment group was smaller than that in the control group (P < 0.05). After treatment, the serum levels of P, iPTH, and AKP in two groups were decreased, while the levels of Ca in two groups were increased (P < 0.05). The serum levels of P, iPTH, and AKP in the treatment group were lower than those in the control group, while the serum levels of Ca were higher than those in the control group (P< 0.05). After treatment, the serum levels of IL-4 and CRP in two groups were significantly decreased, while the serum levels of IFN-γ in two groups were significantly increased (P < 0.05). Moreover, the serum levels of IL-4 and CRP in the treatment group were lower than those of the control group, while the serum levels of IFN-γ in the treatment group were higher than those of the control group (P < 0.05). Conclusion Paricalcitol Injection combined with Sevelamer Carbonate Tablets has clinical effect in treatment of hyperpara-thyroidism secondary to maintenance hemodialysis, can reduce the volume of the patient's thyroid, regulate serum factors such as calcium and phosphorus metabolism, and lower the level of inflammatory factors in the body, with high safety.

R977