摘要
目的观察血管紧张素Ⅱ受体拮抗剂(ARB)替米沙坦是否能延缓腹膜透析患者残存肾功能的丢失及其对血脂代谢的影响。方法将入选的46例维持性腹膜透析患者随机均分为替米沙坦组及对照组。替米沙坦组予以美卡素80mg/d口服,两组患者经过常规降压治疗使目标血压值均达到16～18/9.33～11.33 kPa,观察时间为12个月。所有患者定期(每3个月)测定残存肾功能,检测血白蛋白、血清胆固醇、甘油三脂、低密度脂蛋白、尿素清除指数(Kt/V),肌酐清除率(CCL),记录血压、24 h尿量。结果替米沙坦组与对照组的尿量和残存肾功能变化差异有统计学意义(F=6.15,P<0.01);反映血脂代谢的3个指标,即甘油三酯、血清胆固醇、低密度脂蛋白在研究过程中的变化,两组比较差异有统计学意义(P<0.05)。结论相比其它常规降压药,替米沙坦可能更具有保护持续性非卧床腹膜透析患者的残存肾功能以及稳定血脂代谢的作用。
Objective To observe whether the angiotensin 1I receptor blocker （ARB）, telmisartan can slow the decline of residual renal function and improve the metabolism of lipid in patients on peritoneal dialysis. Methods 46 peritoneal dialysis patients were randomly and evenly divided into ARB study group and control group. The sub- jects in ARB study group were administered 80 mg telmisartan daily. Through antihypertensive therapy, the target blood pressure of two groups of patients reached 16 ~ 18/9. 33 - 11.33 kPa within the 12-month observation period. The e-GFR of all patients were decteeted every three months. The levels of albumin, cholesterol, triglyeeride and low density lipoprotein, Kt/V, CCL, and blood pressure, 24 hours urinary volume were also detected before and after the experiment. Results Over 12 months, the urine volume and residual renal function both were decreased in the control group, but did not reach the significant level（P 〉0.05） , while in ARB study group, these two pa- rameters all declined significantly （ P 〈 0. 05 ）. The cholesterol, triglyceride and low density lipoprotein were all declined significantly in ARB study group （P 〈 0. 05）. Conclusion Compared with other antihypertensive drugs, telmisartan may protect the residual renal function and stabilize the metabolism of lipid in patients with regular peri- toneal dialysis.
出处
《安徽医科大学学报》
CAS
北大核心
2013年第2期174-177,共4页
Acta Universitatis Medicinalis Anhui
基金
安徽省卫生厅医学科研课题(编号:2009C215)
关键词
替米沙坦
腹膜透析
残存肾功能
血脂
telmisartan
peritoneal dialysis
residual renal function
lipid
