羟苯磺酸钙治疗慢性移植肾功能不全的临床观察

背景：羟苯磺酸钙作为一种血管保护剂被广泛用于治疗慢性静脉功能不全和糖尿病肾病，尤其大量临床研究表明它可以减轻糖尿病肾病的肾损害，但很少有关于羟苯磺酸钙用于治疗肾移植后慢性移植肾功能不全的文献报道。目的：观察羟苯磺酸钙治疗慢性移植。肾功能不全的有效性和安全性。方法：收集解放军第二军医大学附属长征医院全军器官移植研究所收治的152例肾移植后出现慢性移植肾功能不全的患者，分为治疗组（n=78）和对照组（n=74）。治疗组患者口服羟苯磺酸钙500mg3次，d，连续服用8周。所有患者均接受钙调磷酸酶抑制剂为基础的免疫抑制方案和综合治疗。结果与结论：对于服用羟苯磺酸钙治疗的患者，其血肌酐、尿素氮和尿酸在治疗第2周时均较治疗前明显下降并维持稳定（P〈0．05），但血肌酐和尿素氮在停药后立即回复到原基线水平。而两组患者的血常规、肝功能、血脂、电解质、血压及24h尿量在治疗前后差异均无显著性意义（P〉0．05）。服用羟苯磺酸钙并不会对肾功能不全患者的一般情况和免疫抑制剂的血药浓度产生影响。羟苯磺酸钙可能通过自身与血肌酐结合、减轻微循环损伤及其抗氧化的特性延缓慢性移植肾功能不全的进展。同时，服药后血肌酐下降有助于缓解患者的焦虑和担忧。然而，羟苯磺酸钙对血肌酐检测的负性干扰需引起重视，以免对患者病情产生误判。

Clinical observation of calcium dobesilate in the treatment of chronic renal allograft dysfunction

BACKGROUND： Calcium dobesilate （calcium dihydroxy-2, 5-benzenesulfonate） has been widely used to treat chronic venous insufficiency and diabetic retinopathy, especially many clinical studies showed that calcium dobesilate as vasoprotective compound ameliorates renal lesions in diabetic nephropathy. However, there are few literatures reported calcium dobesilate in the treatment of chronic renal allograft dysfunction after renal transplantation. OBJECTIVE： To observe the efficacy and safety of calcium dobesilate on chronic renal dysfunction after renal transplantation. METHODS： A total of 152 patients with chronic renal allograft dysfunction after renal transplantation were enrolled from the Military Institute of Organ Transplantation, Changzheng Hospital, Second Military Medical University of Chinese PLA. They were randomly divided into the treatment group （n=78） and the control group （n=74）. Patients in the treatment group received 500 mg of calcium dobesilate three times daily for eight weeks. All patients were treated with calcineurin inhibitor-based triple immunosuppressive protocols and comprehensive therapies. RESULTS AND CONCLUSION： For patients receiving calcium dobesilate, serum creatinine, blood urea nitrogen and uric acid decreased significantly at two weeks after treatment and maintained a stable level （P 〈 0.05）. However, serum creatinine and blood urea nitrogen returned to the original level soon after drug withdrawal. No significant difference was observed in blood cell count, liver function, blood lipids, electrolytes, blood pressure and 24-hour urine output between the two groups before and after therapy （P 〉 0.05）. Administration of calcium dobesilate did not change the general condition of patients with renal insufficiency, nor did it affect blood concentrations of the immunosuppressive agents. Calcium dobesilate may help to delay the progress of graft injury in patients with chronic .renal graft dysfunction by conjugating with creatinine, ameliorating the impaire