目的 探讨烟酰胺片联合碳酸司维拉姆片治疗血液透析高磷血症的临床疗效。方法 选取2016年3月—2017年3月在云阳县人民医院肾内科维持血液透析的高磷血症患者100例作为研究对象，所有患者随机分为对照组和治疗组，每组各50例。对照组患者餐中口服碳酸司维拉姆片，用量根据具体血磷水平进行调整（当血磷≥2.41 mmol/L，口服剂量为1 600 mg/次；当血磷<2.41 mmol/L，口服剂量为800 mg/次），3次/d；治疗组患者在对照组治疗的基础上口服烟酰胺片，500 mg/次，1次/d。两组患者均连续治疗2个月。观察两组患者的临床疗效，比较治疗前后的血清学指标、冠状动脉钙化积分（CACS）、白细胞介素-6（IL-6）和甲状旁腺激素（PTH）水平。结果 治疗后，对照组和治疗组的临床总有效率分别为78.00%、94.00%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者的血磷、钙磷乘积水平均显著降低，血钙水平显著升高，同组治疗前后比较差异具有统计学意义（P<0.05）；且治疗后治疗组血清学指标显著优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者的CACS、IL-6、PTH水平均显著降低，同组治疗前后比较差异具有统计学意义（P<0.05）；且治疗后治疗组患者CACS、IL-6、PTH水平显著低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 烟酰胺片联合碳酸司维拉姆片治疗血液透析高磷血症患者疗效显著，可显著降低血磷水平，减轻炎性反应，安全性较高，具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Nicotinamide Tablets combined with Sevelamer Carbonate Tablets in treatment of hyperphosphatemia in hemodialysis. Methods Patients (100 cases) with hyperphosphatemia in hemodialysis in Yunyang County People's Hospital from March 2016 to March 2017 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group were po administered with Sevelamer Carbonate Tablets during the meals, the dosage was adjusted according to the specific blood phosphorus levels (blood phosphorus ≥ 2.41 mmol/L, oral dose was 1 600 mg/time; blood phosphorus < 2.41 mmol/L, oral dose was 800 mg/time), three times daily. Patients in the treatment group were po administered with Nicotinamide Tablets on the basis of the control group, 500 mg/time, once daily. Patients in two groups were treated for 2 months. After treatment, the clinical efficacy was evaluated, and serological indicators, CACS, IL-6, and PTH levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 78.00% and 94.00%, respectively, and there were differences between two groups (P<0.05). After treatment, the blood phosphorus, calcium and phosphorus product levels in two groups were significantly decreased, but the blood calcium levels in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). After treatment, serological indicators in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of CACS, IL-6, and PTH in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). After treatment, the levels of CACS, IL-6, and PTH in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Nicotinamide Tablets combined with Sevelamer Carbonate Tablets has a significant effect in treatment of hyperphosphatemia in hemodialysis, can significantly reduce blood phosphorus levels, reduce inflammatory reaction, with high safety,which has a certain clinical application value.