目的 分析司維拉姆治療慢性腎衰竭維持性血液透析患者高磷血癥的臨床療效。方法 以2013年6月-2016年8月間南陽市第一人民醫(yī)院收治的慢性腎衰竭的高磷酸血癥患者80例為研究對象，根據(jù)隨機數(shù)字表法分為觀察組和對照組，每組40例。對照組患者給予醋酸鈣口服，初始劑量1片/次，3次/d；觀察組給予碳酸司維拉姆口服，初始劑量1片/次，3次/d。兩組均連續(xù)治療2個月，治療期間每2周根據(jù)血磷水平調(diào)整劑量。比較兩組治療前后血磷、血鈣、鈣磷乘積、全段甲狀旁腺激素（iPTH）等有效性指標和臨床療效及白介素（IL）-6、腫瘤壞死因子（TNF）-α和超敏C反應(yīng)蛋白（hs-CRP）等血清炎癥因子的水平和不良反應(yīng)。結(jié)果 治療結(jié)束后，兩組的血磷、鈣磷乘積均較治療前顯著降低，且觀察組的顯著低于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。治療結(jié)束后，觀察組的總有效率為92.50%，顯著高于對照組的75.00%，差異有統(tǒng)計學(xué)意義（P<0.05）。兩組的IL-6、TNF-α以及觀察組的hs-CRP均較治療前顯著降低，組內(nèi)差異有統(tǒng)計學(xué)（P<0.05）；且觀察組的顯著低于對照組，組間差異有統(tǒng)計學(xué)意義（P<0.05）。兩組不良反應(yīng)發(fā)生率比較，差異無統(tǒng)計學(xué)意義。結(jié)論 碳酸司維拉姆治療慢性腎衰竭維持性血液透析患者高磷血癥的臨床療效顯著，且可有效降低患者的血清炎癥因子，安全可靠。

Objective To investigate the clinical effect of sevelamer in hyperphosphatemia of chronic renal failure patients with maintenance hemodialysis. Methods Chronic renal failure patients (80 cases) with maintenance hemodialysis and hyperphosphatemia in The First People's Hospital of Nanyang from July 2013 to August 2016 were selected and divided into observation group and control group, 40 cases in each group. Patients in control group were treated with calcium acetate, and patients in observation group were treated with sevelamer. The effectiveness indexes (serum phosphorus, serum calcium, calcium-phosphorus product and iPTH), clinical effect, interleukin (IL) 6, tumor necrosis factor (TNF)-α, hypersensitive c-reactive protein (hs-CRP), and adverse reaction before and after treatment were compared. Results After treatment, the serum phosphorus and calcium-phosphorus product of two groups were significantly lower than before treatment (P<0.05), and the observation group were significantly lower than control group (P<0.05). After treatment, the total effective rate of the observation group was 92.50%, significantly higher than 75% of the control group, and the difference was statistically significant (P<0.05). The levels of IL-6 and TNF-α in two groups and hs-CRP level in observation group were significantly lower than those before treatment (P<0.05); The observation group was significantly lower than control group, and the difference between two groups was statistically significant (P<0.05). The difference in the adverse reaction rate had no significant between two groups. Conclusion Sevelamer Carbonate Tablets have remarkable clinical effect in hyperphosphatemia of chronic renal failure patients with maintenance hemodialysis, and can effectively reduce the serum levels of inflammatory cytokines, which is safe and reliable.