羟苯磺酸钙对维持性血液透析患者微炎症状态的影响

目的通过观察羟苯磺酸钙对维持性血液透析患者相关炎症和营养指标超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、白蛋白(ALB)、前白蛋白(PA)、转铁蛋白(TF)的影响,探讨其对维持性血液透析患者微炎症状态的作用。方法将武汉大学医学院同仁医院肾内科60例维持性血液透析患者,随机分为治疗组30例和对照组30例。同时选择30例体检健康者为健康对照组。在常规血液透析治疗基础上,治疗组每次口服羟苯磺酸钙0.5g,每日3次。对照组口服阿托伐他汀10mg,每日1次。健康对照组无治疗。时间为12周。分别在实验开始、4周、12周检测患者血清hs-CRP、IL-6、白蛋白、前白蛋白、转铁蛋白浓度。结果和实验开始时相比,实验4周时治疗组与对照组hs-CRP、IL-6均明显降低,白蛋白、前白蛋白与转铁蛋白均显著升高(P<0.05),且除了对照组前白蛋白以外其他指标均随着时间的延长差异越明显(P<0.01)。但治疗组与对照组组间比较结果差异无统计学意义。健康对照组实验前各项指标分别与治疗组、对照组相比差异有统计学意义(P<0.05)。结论羟苯磺酸钙可明显降低维持性血液透析患者血液hs-CRP、IL-6浓度,显著升高白蛋白、前白蛋白及转铁蛋白浓度,改善患者微炎症及营养状态,且随着时间的延长作用越明显,临床疗效与阿托伐他汀相似。

Effects of calcium dobesilate on microinflammatory state in maintenance hemodialysis patients

Objective To study the changes of serum hypersensitive C-reactive protein(hs- CRP),interleukin-6 (IL-6), albumin, prealbumin and transferrin level in maintenance hemodialy- sis patients after taking calcium dobesilate for 12 weeks and the effects of calcium dobesilate on microinflammatory state. Methods Sixty maintenance hemodialysis patients in our dialysis center were enrolled.All patients were randomly divided into treatment group(16 males and 14 females) and control group (15 males and 15 females).While Thirty normal medical examination adults were selected as healthy control group.Patients in treatment group took calcium dobesilate (1.5 a day) for 12 weeks while patients in control group took calcium atorvastatin(10mg a day) in additon to routine hemodialysis therapy. Healthy control group took no medicines.Serum hs- CRP, IL-6, albumin , prealbumin and transferrin concentration were measured at the experiment onset, 4 weeks and 12 weeks later. Results Compared to experiment onset,the hs-CRP and IL-6 level were obviously decreased in treatment group and control group after 4 weeks, and albumin, prealbumin and transferrin concentrations were significantly increased. Except for prealbumin of control group,the longer the duration of the experiment,the more significant of the changes of all markers (P<0.01).The were no significant difference betwen treatment group and control group. Conclusion Calcium dobesilate can reduce serum levels of hs-CRP, IL - 6, and increase albumin,prealbumin and transferrin levels and can improve the microinflammatory state in maintenance hemodialysis patients.This effect is more obviously along with the time prolongation. The clinic curative effect of calcium dobesilate is similar with calcium atorvastatin.