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缬沙坦对持续性不卧床腹膜透析者腹膜功能的影响
引用本文:郭林,贺小霞. 缬沙坦对持续性不卧床腹膜透析者腹膜功能的影响[J]. 国外医学(移植与血液净化分册), 2013, 0(5): 38-41
作者姓名:郭林  贺小霞
作者单位:河南省焦作市人民医院肾内科,454000
摘    要:目的 探讨血管紧张素受体拮抗剂缬沙坦对长期腹膜透析者腹膜功能的影响.方法 选择在焦作市人民医院接受腹膜透析者51例,采用数字表法随机分为缬沙坦组(n=28)和对照组(n=23),对照组未服用血管紧张素转化酶抑制剂/血管紧张素受体拮抗剂类药物.观测并比较基线及1年后估计肾小球滤过率,行腹膜平衡实验,检测超滤量、透析液/血清肌酐(4 h)比值、透析液/葡萄糖浓度(4 h)比值.采用ELISA法检测隔夜腹膜透析液中转化生长因子β1以及血管内皮生长因子的含量.采用t检验进行数据统计.结果 基线时,两组患者临床资料差异无统计学意义(P>0.05).1年时,缬沙坦组与对照组估计肾小球滤过率均下降,分别为(3.1±1.8)、(2.1±1.9) ml/min,但对照组下降更为明显,与缬沙坦组比较差异有统计学意义(P<0.05).两组透析液/血清肌酐比值、透析液葡萄糖浓度比值差异无统计学意义,对照组超滤量增加更为明显,两组比较差异有统计学意义[对照组:基线时(351±210)ml/4 h,1年时(445±209) ml/4 h;缬沙坦组:基线时(336±198)ml/4 h,1年时(391±220)ml/4 h;P<0.05].干预后,对照组转化生长因子β1和血管内皮生长因子的表达明显增加,与基线比较差异有统计学意义(P<0.05),而缬沙坦组干预前后转化生长因子β1和血管内皮生长因子的表达差异无统计学意义.结论 血管紧张素受体拮抗剂缬沙坦对腹膜透析者残余肾功能具有保护作用,可延缓腹膜透析者超滤衰竭的发生,抑制腹透液中腹膜纤维化相关因子的表达,进而抑制、延缓腹膜纤维化的发生和发展,保护腹膜功能.

关 键 词:腹膜透析  残余肾功能  腹膜纤维化  血管紧张素受体拮抗剂  缬沙坦

Effects of valsartan on peritoneal function in patients undergoing peritoneal dialysis
GUO Lin,HE Xiao-xia. Effects of valsartan on peritoneal function in patients undergoing peritoneal dialysis[J]. , 2013, 0(5): 38-41
Authors:GUO Lin  HE Xiao-xia
Affiliation:1.Department of Kidney Diseases, the People's Hospital of Jiaozuo City, Jiaozuo 454000, China;)
Abstract:Objective To investigate the effects of the angiotensin receptor blocker (ARB) valsartan on peritoneal function in patients undergoing peritoneal dialysis.Methods Fifty-one patients undergoing continuous ambulatory peritoneal dialysis (CAPD) in our department were randomly assigned to the valsartan group (n =28) or the control group (n =23).Those of the control group were administered with antihypertensive agents except ACE inhibitors and angiotensin receptor blockers (ARBs).At baseline and 1 year,estimated glomerular filtration rate (eGRF),ultrafiltration (UF),dialysis/plasma creatinine (D/Pcr) and D/D0 were measured.In the PET,transforming growth factor-β1 (TGF-β1) and vascular endothelial growth factor (VEGF) in the overnight dialysate were tested by using ELISE.t test was used for data analysis.Reesult Baseline clinical characteristics were not significantly different between the two groups.At 1 year,eGRF was decreased to (3.1 ± 1.8) ml/min in the valsartan group and to (2.1 ± 1.9) ml/min in the control group (P < 0.05).The ultrafiltration volume was higher in the control group than the valsartan group ((391 ± 220) vs (445 ± 209) ml/4 h,P < 0.05).TGF-β1 and VEGF of the 2 groups were increased,while the change in the control group showed statistically significant difference (P < 0.05).Conclusion In CAPD patients,valsartan can delay the occurrence of altrafiltration failure and protect against peritoneal fibrosis.
Keywords:Peritoneal dialysis  Residual renal function  Peritoneal fibrosis  Angiotensin receptor blocker  Valsartan
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