目的 研究西那卡塞聯(lián)合骨化三醇治療尿毒癥血液透析繼發(fā)性甲狀旁腺功能亢進患者的臨床療效。方法 選擇2016年1月-2018年12月新疆喀什地區(qū)第一人民醫(yī)院的96例尿毒癥血液透析繼發(fā)性甲狀旁腺功能亢進患者作為研究對象。采用抽簽法將患者隨機分為對照組和觀察組，每組各48例。對照組口服骨化三醇膠丸，初始給藥劑量為0.25 μg/d，3次/周，每15天調整1次給藥劑量，最高劑量為0.5 μg/d。觀察組在對照組治療的基礎上整片吞服鹽酸西那卡塞片，初始給藥劑量為25 mg/d，每15天調整1次給藥劑量，最高劑量為75 mg/d。兩組均持續(xù)治療3個月。觀察兩組患者的臨床療效，比較兩組治療前后的相關血清學指標和甲狀旁腺體積。結果 治療后，觀察組的有效率為93.75%，明顯高于對照組的77.08%，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療后，兩組的血鈣水平和鈣磷乘積明顯升高，血磷、血清全段甲狀旁腺激素（iPTH）水平明顯降低，觀察組的血清成纖維細胞生長因子23（FGF23）和骨特異性堿性磷酸酶（BSAP）水平明顯降低（P<0.05），且觀察組的血清指標水平明顯優(yōu)于對照組（P<0.05）。兩組治療后的甲狀旁腺體積均明顯降低（P<0.05），觀察組明顯更低（P<0.05）。結論 西那卡塞聯(lián)合骨化三醇可以有效緩解患者的鈣磷代謝異常情況，明顯降低血清BSAP和FGF23水平，且不會使不良反應增加。

Objective To study the clinical efficacy of cinacalcet combined with calcitriol in treatment of secondary hyperparathyroidism in uremia hemodialysis patients. Methods A total of 96 patients with secondary hyperparathyroidism in uremia hemodialysis in First People's Hospital of Kashgar from January 2016 to December 2018 were selected as study subjects. The patients were randomly divided into control group and observation group by lottery, with 48 patients in each group. Patients in the control group were po administered with Calcitriol Soft Capsules, the initial dose was 0.25 μg/d, three times weekly, and the dose was adjusted once every 15 days. The maximum dose was 0.5 μg/d. Patients in the observation group were po administered with Cinacalcet Hydrochloride Tablets on the basis of the control group, the initial dose was 25 mg/d, and the dose was adjusted once every 15 days, with the highest dose being 75 mg/d. Both groups were treated continuously for 3 months. After treatment, the clinical efficacy in two groups was observed, and the relevant serological indexes and parathyroid volume before and after treatment were compared between two groups. Results After treatment, the effective rate of the observation group was 93.75%, which was significantly higher than 77.08% of the control group, and the difference between two groups was statistically significant (P<0.05). After treatment, serum calcium and calcium phosphorus product were significantly increased, but the levels of serum phosphorus and serum iPTH were significantly decreased, and serum FGF23 and BSAP levels of the observation group were significantly decreased (P<0.05). And serum index levels of the observation group were significantly better than those of the control group (P<0.05). After treatment, the volume of parathyroid glands in two groups was significantly reduced (P<0.05), while that in the observation group was significantly lower (P<0.05). Conclusion The combination of cinacalcet and calcitriol can effectively alleviate the abnormal calcium and phosphorus metabolism in patients, significantly reduce the serum BSAP and FGF23 levels, and will not increase the adverse reactions.

R977