Abstract:

Objective To observe the safety and effectiveness of elcatonin in prevention of femoral headnecrosis after kidney transplantation. Methods 235 cases of kidney transplantation patients from the Second People's Hospital of Shanxi kidney dialysis center from January 2006 to December 2008 were enrolled. 59 cases of kidney transplantation patients from January 2008 to December 2008 were assorted into experimental group，while 176 cases of kidney transplantation patients from January 2006 to December 2007 as control. Patients in the experimental group started intramuscular injection of elcatonin one week after kidney transplantation with 20 U，1-2 times a week， for three consecutive months as a course. Thereafter the treatment course was repeated every three other months for3 courses，during which oral calcium carbonate D3 tablets was taken orally ，600-1 200 mg/d. Elcatonin was not used in control，while calcium carbonate D3 tablets，600-1 200 mg/d，and active vitamin D3 capsule were orally taken. The observation last to 18 to 30 months after operation. Results No case of femoral head necrosis or elcatonin related adverse reactions was happened in experimental group during the observation period. There were 5 cases（2.84%）of femoral head necrosis happened in 176 cases of patients in the control，and all occurred 6 to 18 months after operation，which were statistically significant between the two groups（P＜0.05）. Conclusions The quality of life of uremic patients can be improved with kidney transplantation，but preoperative concurrent renal bone disease and postoperative long-term use of corticosteroids are both important factors leading to femoral head necrosis，in turn produces more severe，irreversible damage，affecting the quality of life and long-term survival of patients.Elcatonin injection postoperation can significantly reduce the incidence of femoral head necrosis. It is a safe andeffective prevention measure，and can significantly improve the quality of survivors through clinical observation.

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摘要：

目的 观察肾移植术后使用依降钙素预防股骨头坏死的安全性和有效性。方法 本研究为回 顾性分析，研究对象为山西省第二人民医院肾移植透析中心 2006 年 1 月至 2008 年 12 月 235 例肾移植患 者。将 2008 年 1 月至 2008 年 12 月实施肾移植的 59 例患者作为试验组，将 2006 年 1 月至 2007 年 12 月 实施肾移植的 176 例患者作为对照组。试验组肾移植后 1 周即开始肌注依降钙素 20 U，每周 1～2 次，连 续 3 个月作为 1 个疗程，此后每隔 3 个月使用 1 个疗程，共使用 3 个疗程，此期间配合口服碳酸钙 D3 片 600～1 200 mg/d ；对照组不使用依降钙素，口服碳酸钙 D3 片 600～1 200 mg/d、活性维生素 D3 胶丸，观察 至术后 18～30 个月。结果 在观察期内试验组未发现股骨头坏死病例，也未出现任何与依降钙素相关的不良反应 ；对照组 176 例患者中发生股骨头坏死 5 例（发生率 2.84%），均发生于术后 6～18 月，两组比较差异有统计学意义（P＜0.05）。结论 尿毒症患者接受肾移植治疗可以提高患者的生活质量，但肾移植术前并发肾性骨病及术后长期服用糖皮质激素均是导致股骨头坏死的重要因素，继而产生更为严重的、不可逆 转的伤害，影响肾移植患者的生存质量及长期存活率。采用术后阶段性注射依降钙素可明显减少股骨头坏死的发生，临床观察显示是安全有效的预防措施，可显著提高患者生存质量。

关键词: 肾移植 , 股骨头坏死 , 依降钙素