烟酰胺治疗维持性血液透析患者高磷血症的疗效观察

《烟酰胺治疗维持性血液透析患者高磷血症的疗效观察》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、万方数据温州医科大学硕士学位论文mmoFL比(2．35+0．36)mmol／L]均无统计学差异。烟酰胺不良反应为胃肠道反应(恶心、腹泻为主)、皮肤瘀斑、头痛等。烟酰胺治疗组血小板较基础值下降>30％的患者较对照组增加，二者具有显著性统计学差异(尸=0．000)。结论本研究表明在服用磷结合剂治疗的基础上加用烟酰胺可对维持性血液透析高磷血症患者起到良好的降磷作用，并带来升高高密度脂蛋白的益处。主要不良反应为胃肠道反应和血小板减少，在治疗时需监测患者血小板。关键词：烟酰胺；高磷血症：肾透析；甲状旁腺素万方数据温州医

2、科大学硕士学位论文EffectivenessofNiacinamideUsedonHyperphosphatemiaPatientsUndergoingHemodialysisAbstractObjectiveTostudytheeffectivenessandsafetyofniacinamideintreatingmaintenancehemodialysispatientswithhyperphosphatemia．MethodsItwasaprospectiveandrandomizedcontrol

3、ledtrial．Patientswithhyperphosphatemia(scramphosphate>1．45mmol／L)wererecruitedfromthehemodialysiscenteroftheFirstAffiliatedHospitalOfWenzhouMedicalUniversityandrandomlyassignedintotwogroups，controlgroupandniacinamidetherapygroup．Bothgroupsmaintainedtheftori

4、ginaldietaryhabit，dialysisscheme(dialysismode，dialysismembranematerial，weeklydialysistime，calciumconcentrationindialysissolution)，phosphatebinderandRocaltroltreatment．Niacinamidetherapygroupadditionallyreceivedniacinamide．ThestartingdosageWaS600mgperday．The

5、maximumdosageWas1200mgperday．Basicalmedicinesuchasantihypertensivedrug，ferralia，erythropoietin，levocarnitinecouldbeadjustedaccordingtopatient’Scondition．However,medicinewhichcouldinfluencetheabsorptionofphosphateorcalciumWasforbiddentobechanged．Thetreatment

6、lastedfor8weeks．NormalizedproteincatabolicrateWasmonthlytestedtoevaluatedietaryintake．Serumphosphateandcalciumweretestedevery2weeks，iPTH，hemoglobin，bloodplatelet，albumin，alkalinephosphatase，totalcholesterol，highdensitylipoprotein，lowdenskylipoprotein，trigly

7、cerideandotherrelevantindexesweretestedmonthly．Results100patientswererecruitedand93ofthemcompletedthetrial，including44fromthetherapygroupand49fromthecontrolgroup．Thereisnosignificantdifferencebetweentwogroupsinage，dialysisage，gender'weight，prescriptionofpho

8、sphatebindersandRocaRroLintakeofmedicinalcalcium，ureaclearanceindex，normalizedproteincatabolicrate．Beforethisexperiment，serumphosphatelevelintherapygroupWas1．95mmol／L，whilecontrolgroupWas1．93mmol／L．Att