目的 探究蔗糖羟基氧化铁与醋酸钙联合使用治疗慢性肾脏病高磷血症患者的临床疗效，已期为临床优化降磷治疗方案提供循证依据。方法 回顾性分析平阳县人民医院2023年3月—2025年9月收治的120例慢性肾脏病高磷血症患者临床资料，按照治疗方法不同分为对照组和治疗组，每组各60例。对照组给予醋酸钙胶囊，随餐服用2粒，根据血磷水平2～4周调整剂量，最大剂量每日不可超过8粒。治疗组在对照组治疗基础上随餐咀嚼蔗糖羟基氧化铁咀嚼片，起始剂量1片/次，3次/d。两组均连续治疗3个月。观察两组的临床疗效比较两组血磷水平、成纤维细胞生长因子23（FGF23）、血钙、钙磷乘积、生活质量评分。结果 治疗后，治疗组总有效率96.67%显著高于对照组的80.00%（P＜0.05）。治疗1、3个月，两组血清磷水平均较同组治疗前显著下降（P＜0.05）；且治疗组患者治疗1、3个月血清磷水平低于对照组（P＜0.05）。治疗1、3个月治疗组血磷达标率均高于对照组（P＜0.05）。治疗后，两组患者钙磷乘积、FGF23均显著降低，血钙升高（P＜0.05）；治疗后治疗组患者钙磷乘积、FGF23水平均低于对照组（P＜0.05），两组血钙水平比较差异无统计学意义。治疗后，两组慢性肾脏病生活质量量表（KDQOL-36）评分中SF-12、肾病负担、症状与问题、肾病影响及总评分均较治疗前显著升高（P＜0.05）；治疗后，治疗组患者KDQOL-36中SF-12、肾病负担、症状与问题、肾病影响及总评分均高于对照组（P＜0.05）。结论 蔗糖羟基氧化铁咀嚼片联合醋酸钙胶囊治疗慢性肾脏病高磷血症可提高临床疗效，降低血磷、FGF23等异常血清指标，促进血磷达标，提高患者生活质量，值得临床推广应用。

Objective To explore the clinical efficacy of sucroferric oxyhydroxide combined with calcium acetate in treatment of hyperphosphatemia in chronic kidney disease, in order to provide evidence-based basis for optimizing the clinical treatment plan for phosphorus reduction. Methods A retrospective analysis was conducted on the clinical data of 120 patients with hyperphosphatemia in chronic kidney disease who were admitted to Pingyang County People’s Hospital from March 2023 to September 2025. The patients were divided into control group and treatment group based on different treatment methods, with 60 cases in each group. Patients in control group were given Calcium Acetate Capsules, 2 capsules with each meal, and the dosage was adjusted according to blood phosphorus level every 2 to 4 weeks, with a maximum daily dose not exceeding 8 capsules. Patients in treatment group took Sucroferric Oxyhydroxide Chewable Tablets on basis of control group’s treatment, starting with a dose of 1 tablet per time, 3 times daily. Both groups received continuous treatment for 3 months. The clinical efficacy was observed, and blood phosphorus levels, fibroblast growth factor 23 (FGF23), blood calcium, calcium-phosphorus product, and life quality scores of two groups were compared. Results After treatment, the total effective rate of the treatment group was 96.67%, significantly higher than that of the control group (80.00%) (P < 0.05). At 1 and 3 months of treatment, the serum phosphorus levels of both groups decreased significantly compared to those before treatment in same group (P < 0.05). And the serum phosphorus levels of patients in treatment group at 1 and 3 months were lower than those in control group (P < 0.05). At 1 and 3 months of treatment, the phosphorus level reaching the standard rate in treatment group was higher than that in control group (P< 0.05). After treatment, the calcium-phosphorus product and FGF23 levels in both groups significantly decreased, and the blood calcium levels increased (P< 0.05). After treatment, the calcium-phosphorus product and FGF23 levels in the treatment group were lower than those in the control group (P < 0.05), while there was no statistically significant difference in the blood calcium levels between the two groups. After treatment, KDQOL-36 score, SF-12 score, nephropathy burden score, symptom and problem score, nephropathy impact score and total score of two groups significantly increased compared to those before treatment (P < 0.05). KDQOL-36 score, SF-12 score, nephropathy burden score, symptom and problem score, nephropathy impact score and total score in treatment group were higher than those of control group (P < 0.05). Conclusion The combination of sucroferric oxyhydroxide and calcium acetate can improve clinical efficacy in treatment of hyperphosphatemia in chronic kidney disease, reduce abnormal serum indicators such as blood phosphorus and FGF23, promote the achievement of normal blood phosphorus levels, and enhance the life quality of patients. It is worthy of clinical promotion and application.

R983