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目的 :研究小剂量口服罗盖全治疗慢性肾衰竭 (CRF)继发性甲旁亢 (SHPT)早期患者的疗效和副作用。方法 :将观察期间 (3～ 12个月 )血清全段甲状旁腺激素 (iPTH)浓度动态升高且高达正常值 3～ 5倍的 180名CRF患者随机分为A、B两组 ,A组予罗盖全 0 .12 5 μg/d ,B组予罗盖全 0 .2 5 μg/d口服 ,以血清iPTH浓度降至正常值2 .5倍即 16 0ng/L为观察终点 ;另将血清iPTH浓度高达正常值 5倍以上的 15 3例患者随机分为C、D两组 ,C组予罗盖全 0 .5 μg/d上午口服 ,D组以相同剂量于晚上 10h口服 ,以血清iPTH浓度降至正常值 3倍即 195ng/L为观察终点。以到达终点的例数和时间为指标判断疗效 ,分别比较A、B两组及C、D两组疗效和高钙血症等副作用。结果 :各组均取得良好疗效。B组有效率 90 .91% ,明显高于A组的 5 7.30 % (P <0 .0 1) ,B组到达终点时间 (8.6 6± 3.2 )个月 ,明显早于A组 (15 .2 4± 3.7)个月 (P <0 .0 1)。C、D两组疗效相近 ,有效率分别为 86 .89%和 84 .2 9% (P >0 .0 5 ) ,到达终点的时间分别为 (9.5 1± 3.1)个月和 (9.97± 2 .9)个月 (P >0 .0 5 )。各组均无发生血清iPTH浓度过低 (<130ng/L)。A、B两组极少发生高钙血症 ,发生率分别为 1.11%和 2 .2 2 % ;D组高钙血症发生率为 9.72 % ,明显低于C组的
Objective: To study the curative effect and side effects of low dose oral administration of captopril in patients with early stage of secondary hyperparathyroidism (SHPT) of chronic renal failure (CRF). Methods: One hundred and eighty CRF patients with dynamically elevated serum parathyroid hormone (iPTH) concentrations during the observation period (3-12 months) were randomly divided into A and B groups. A group 0.265 μg / d was given to lidocaine, 0.25 μg / d was given to lidocaine in group B, and the serum iPTH concentration was reduced to 2.5 times the normal value of 165 ng / L as the end point of observation. Serum iPTH concentrations up to 5 times the normal value of more than 15 3 patients were randomly divided into C, D two groups, C group to Lo cap full 0. 5 μg / d orally, D group with the same dose of oral 10h, with serum iPTH concentration dropped to normal 3 times 195ng / L for the end of the observation. To reach the end of the number of cases and time as indicators to determine efficacy, respectively, A and B groups and C, D two groups of side effects such as efficacy and hypercalcemia. Results: All groups achieved good results. The effective rate in group B was 90.91%, which was significantly higher than that in group A (7.30%, P <0.01). The mean time to endpoint in group B was (8.6 ± 3.2) months, significantly earlier than that in group A 4 ± 3.7) months (P <0.01). The effective rates were 86.89% and 84.29% (P> 0.05) respectively in C and D groups, and reached 9.51 ± 3.1 months and 9.97 ± 2 months respectively .9) months (P> 0.05). Serum iPTH levels were low (<130 ng / L) in all groups. The incidences of hypercalcemia in groups A and B were very low, with rates of 1.11% and 2.2.2% respectively. The incidence of hypercalcemia in group D was 9.72%, which was significantly lower than that in group C