关键词: 帕立骨化醇, 西那卡塞, 继发性甲状旁腺功能亢进, 血液透析

Abstract: Ｏｂｊｅｃｔｉｖｅ：To observe efficacy and safety of paricalcitol combin with cinacalcet in treatment of refractory secondary hyperparathyroidism(SHPT)in maintenance hemodialysis(MHD) patients.
Ｍｅｔｈｏｄｏｌｏｇｙ：A retrospective study was conducted in MHD patients with SHPT whose serum intact parathyroid hormone (iPTH) was still >800 pg／mL, although treated with calcitriol and cinacalcet, Serum levels of calcium, phosphorus, iPTH, alkaline phosphatase, calcium phosphorus product and hemoglobin were measured at baseline, 4 and 12 weeks after treatment.
Ｒｅｓｕｌｔｓ：Twelve patients were enrolled in this study(6 males and 6 females), the baseline iPTH was 129165±37096 pg／mL, serum calcium was 225±029 mmol／L, and serum phosphorus was 212±058 mmol／L. The initial dose of paricalcitol is 5 μg, tiw, combined with cinacalcet 25～50 mg／d. After 4 weeks of treatment, iPTH decreased to 89557 ± 47942 pg／mL(P=0054), the proportion of patients with iPTH reduction rate>30％ and with iPTH reduction to 150～585 pg／mL was 333％ and 25％ respectively; After 12 weeks of treatment, iPTH level was 79491±41712 pg／mL(P=0011), the proportion of patients with iPTH reduction rate>30％ and with iPTH reduction to 150～585 pg／mL was 583％ and 333％ respectively. The mean decline rate of iPTH was 3659±2448％(22％～919％). Compared with the baseline, there was no statistical difference with serum phosphorus and calcium during follow up. No adverse events were observed.
Ｃｏｎｃｌｕｓｉｏｎ：Paricalcitol combined with cinacalcet can reduce the level of iPTH in MHDSHPT patients safely and effectively.

Key words: paricalcitol, cinacalcet, secondary hyperparathyroidism, hemodialysis