西那卡塞联合小剂量骨化三醇治疗维持性血液透析患者继发性甲状旁腺功能亢进疗效的Meta分析

doi:10.16389/j.cnki.cn42-1737/n.2022.01.009

江汉大学学报（自然科学版） ›› 2022, Vol. 50 ›› Issue (1): 65-71.doi: 10.16389/j.cnki.cn42-1737/n.2022.01.009

西那卡塞联合小剂量骨化三醇治疗维持性血液透析患者继发性甲状旁腺功能亢进疗效的Meta分析

成进华¹，王敏¹，胡劲涛¹，吴扬²，李华²，尚伟锋^*2

1. 仙桃市江汉医院，湖北仙桃 433099；2. 武汉市第四医院华中科技大学同济医学院附属普爱医院肾病内科，湖北武汉 430033

发布日期:2022-02-22
通讯作者: 尚伟锋
作者简介:成进华（1981— ），女，住院医师，研究方向：慢性肾脏病一体化治疗。

Meta-analysis of the Efficacy of Cinacalcet Combined with Low-dose Calcitriol in the Treatment of Secondary Hyperparathyroidism in Maintenance Hemodialysis Patients

CHENG Jinhua¹，WANG Min¹，HU Jintao¹，WU Yang²，LI Hua²，SHANG Weifeng^*2

1. Jianghan Hospital of Xiantao，Xiantao 433099，Hubei，China；2. Department of Nephrology，Wuhan Fourth Hospital，Puai Hospital，Tongji Medical College，Huazhong University of Science and Technology，Wuhan 430033，Hubei，China

Published:2022-02-22
Contact: SHANG Weifeng

摘要/Abstract

摘要： 目的 系统评价西那卡塞联合小剂量骨化三醇治疗维持性血液透析患者继发甲状旁腺功能亢进（secondary hyperparathyroidism，SHPT）的疗效。方法 利用计算机检索PubMed、万方、中国知网数据库中关于西那卡塞联合小剂量骨化三醇和西那卡塞治疗血液透析患者SHPT疗效比较的文献，检索时间从建库至2020 年11 月1 日，采用Rev Man 5.1 软件进行Meta 分析。结果 最终有10 篇文献纳入Meta 分析，共计726 例患者。Meta 分析结果显示：与西那卡塞组相比，西那卡塞联合小剂量骨化三醇组降低iPTH［MD ＝ -89. 41，95%CI（-120. 36，-58. 46），P < 0. 000 01］、升高血钙［MD ＝ 0. 37，95%CI（0. 28，0. 46），P < 0. 000 01］、降低血磷［MD ＝ -0. 24，95%CI（-0. 33，-0. 15），P < 0. 000 01］、降低碱性磷酸酶［MD ＝ -32. 35，95%CI（-41. 52，-23. 18），P < 0. 000 01］、缩小甲状旁腺体积［MD ＝ -0. 31，95%CI（-0. 39，-0. 23），P < 0. 000 01］、降低不良反应发生率［OR ＝ 0. 20，95%CI（0. 09，0. 44），P < 0. 000 1］。结论 西那卡塞联合小剂量骨化三醇治疗血液透析患者SHPT 临床疗效优于西那卡塞组，不良反应发生率更低。

关键词: 骨化三醇, 西那卡塞, 继发性甲状旁腺功能亢进, 血液透析, Meta 分析

Abstract: Objective To systematically evaluate the efficacy of cinacalcet combined with low-dose calcitriol in treating maintenance hemodialysis patients with secondary hyperparathyroidism. Methods We searched PubMed，Wanfang，and CNKI databases to collect clinical research results on comparing the efficacy of cinacalcet combined with lowdose calcitriol and cinacalcet in the treatment of SHPT in hemodialysis patients. The search period was from establishing the database to November 1，2020. The Rev Man 5.1 software was used for meta-analysis. Results Finally， 10 studies were included in the metaanalysis，involving 726 patients. Meta-analysis results showed that：compared with the cinacalcet group， cinacalcet combined with low-dose calcitriol group decreased iPTH［MD = -89. 41，95%CI（ -120. 36，-58. 46），P < 0. 000 01］，increased serum calcium ［MD = 0. 37， 95%CI（0. 28，0. 46）， P < 0. 000 01］， decreased serum phosphorus ［MD = -0. 24，95%CI（ -0. 33，-0. 15），P < 0. 000 01］，decreased alkaline phosphatase ［MD = -32. 35，95%CI（-41. 52，-23. 18），P < 0. 000 01］，reduced the volume of parathyroid glands［MD = -0. 31，95%CI（-0. 39，-0. 23），P < 0. 000 01］ and reduced the incidence of adverse reactions ［OR = 0. 20，95%CI（0. 09，0. 44），P < 0. 000 1］. Conclusion The clinical efficacy of cinacalcet combined with lowdose calcitriol in the treatment of SHPT is better than that in the cinacalcet group in hemodialysis patients，and the incidence of adverse reactions is lower.

Key words: calcitriol, cinacalcet, secondary hyperparathyroidism, hemodialysis, Meta analysis

中图分类号:

R692.05

成进华，王敏，胡劲涛，吴扬，李华，尚伟锋. 西那卡塞联合小剂量骨化三醇治疗维持性血液透析患者继发性甲状旁腺功能亢进疗效的Meta分析[J]. 江汉大学学报（自然科学版）, 2022, 50(1): 65-71.

CHENG Jinhua，WANG Min，HU Jintao，WU Yang，LI Hua，SHANG Weifeng. Meta-analysis of the Efficacy of Cinacalcet Combined with Low-dose Calcitriol in the Treatment of Secondary Hyperparathyroidism in Maintenance Hemodialysis Patients[J]. Journal of Jianghan University (Natural Science Edition), 2022, 50(1): 65-71.

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西那卡塞联合小剂量骨化三醇治疗维持性血液透析患者继发性甲状旁腺功能亢进疗效的Meta分析

Meta-analysis of the Efficacy of Cinacalcet Combined with Low-dose Calcitriol in the Treatment of Secondary Hyperparathyroidism in Maintenance Hemodialysis Patients

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