目的 探討碳酸司維拉姆片治療維持性血液透析高磷血癥的臨床療效。方法 選取2018年6月—2019年6月在六安市人民醫(yī)院治療的76例血液透析合并高磷血癥的患者，將所有患者按照數(shù)字隨機(jī)抽取分為對(duì)照組和治療組，每組各38例。對(duì)照組餐中嚼服碳酸鈣D3片，1～2次/d，0.6～1.2 g/d；治療組餐中同服碳酸司維拉姆片，1～2次/d，0.8～1.6 g/d。兩組患者連續(xù)治療6個(gè)月。觀察兩組的臨床療效，比較兩組患者的血磷、血鈣、鈣磷乘積、甲狀旁腺素（PTH）、白蛋白、血紅蛋白水平。結(jié)果 治療后，對(duì)照組總有效率是57.89%，治療組總有效率是76.32%，兩組總有效率比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療3、6個(gè)月后，兩組患者的血磷、鈣磷乘積較治療前均下降（P<0.05）；且治療組的血磷、鈣磷乘積的下降比對(duì)照組更明顯（P<0.05）。治療3、6個(gè)月后，對(duì)照組血鈣顯著升高，治療組血鈣呈下降趨勢(shì)（P<0.05），且治療組的血鈣明顯低于對(duì)照組（P<0.05）。治療3、6個(gè)月后，兩組患者血紅蛋白、白蛋白比較均無明顯差異。治療3、6個(gè)月后，兩組患者PTH均顯著降低（P<0.05），但兩組的PTH對(duì)比無差異。結(jié)論 碳酸司維拉姆片治療維持性血液透析高磷血癥的療效較好，可降低患者血磷、鈣磷乘積，不引起高鈣血癥，對(duì)患者的營(yíng)養(yǎng)狀況沒有影響。

Objective To investigate the clinical study of Sevelamer Carbonate Tablets in treatment of hyperphosphatemia in maintenance hemodialysis. Methods Patients (76 cases) with hyperphosphatemia in maintenance hemodialysis in Lu’an People’s Hospital from June 2018 to June 2019 were randomly divided into control and treatment groups, and each group had 38 cases. Patients in the control group were given Calcium Carbonate and Vitamin D3 Tablets at dinner, 1 — 2 times/d, 0.6 — 1.2 g/d. Patients in the treatment group were given Sevelamer Carbonate Tablets, 1 — 2 times/d, 0.8 — 1.6 g/d. Patients in two groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, and blood phosphorus, blood calcium, calcium phosphorus product, PTH, albumin, and hemoglobin in two groups were compared. Results After treatment, the total effective rate of the control group was 57.89%, and the total effective rate of the treatment group was 76.32%, and the total effective rate of the two groups was statistically significant (P<0.05). After treatment for 3 and 6 months, the blood phosphorus and phosphorus products of the two groups were decreased (P<0.05), and the blood phosphorus and phosphorus products in the treatment group were significantly lower than those in the control group (P<0.05). After treatment for 3 and 6 months, the serum calcium in the control group were significantly increased, but the blood calcium in the treatment group showed a downward trend (P<0.05), and after treatment for 3 and 6 months, the serum calcium in the treatment group was significantly lower than that in the control group (P<0.05). There was no significant difference in hemoglobin and albumin between two groups before and after treatment. After treatment, the PTH of the two groups were significantly decreased (P<0.05), but there was no difference between two groups. Conclusion Sevelamer Carbonate Tablets has clinical curative effect in treatment of hyperphosphatemia in maintenance hemodialysis, can reduce the blood phosphorus, and calcium and phosphorus products, not cause hypercalcemia, and has no effect on the nutritional status of patients.

R983