小剂量阿司匹林用于慢性肾脏病患者的效果观察

目的探讨慢性肾脏病(CKD)患者应用阿司匹林的临床效益和风险。方法选择慢性肾脏病(Scr265～442μmol/L)患者214例,剔除12例消化道出血者,最终202例患者进入临床研究,并随机分为2组。观察组101例,给予基础治疗及阿司匹林(75 mg/d口服);对照组101例,给予基础治疗及安慰剂(3粒/d)。2组均随访2年,以Scr水平较基线值增加1倍,或需要进入血液透析作为为主要研究终点,以主要心血管事件作为次要研究终点。结果 (1)治疗2年后,观察组和对照组达到主要终点事件发生率分别为22.8%、24.8%(P>0.05)。(2)观察组次要心血管事件发生率明显低于对照组(5.9%vs 20.8%,P<0.01)。(3)观察组不良反应发生率高于对照组,但差异无统计学意义(8.0%vs 3.0%,P>0.05)。结论慢性肾脏病患者应用阿司匹林可以明显降低心血管疾病的发生率,且安全性较好。

Clinical study of low dose aspirin in patients with chronic kidney disease

Objective To investigate the benefit and risk of aspirin in chronic kidney disease(CKD) patients. Methods 214 CKD patients were selected,whose serum creatinine(Scr) levels were 265～442μmol/L without cardiovascular disease.12 patients quitted because of gastrointestinal bleeding.The remaining 202 CKD patients were randomly divided into two groups.Observation group(n = 101) were given basic treatment and aspirin(75 mg/d),and control group(n = 101) were given basic treatment and placebo(3 tablets/d).All patients were followed for two years.Doubling of the baseline Scr level or end-stage renal disease with need of dialysis was regarded as the major end point of the trial,and major cardiovascular events was regarded as the minor end point of the trial.Results(1) By the end of two years,the percentages of cases which reaching the major end point in observation group and control group were 22.8%and 24.8%(P >0.05).(2) The incidence of major cardiovascular events in observation group was significantly lower as compared to control group(5.9%vs. 20.8%,P <0.01).(3) The incidence of adverse effects was higher in observation group than that in control group but no statistical significance was found(8.0%vs.3.0%,P > 0.05).Conclusion Aspirin is safe for CKD patients,and may reduce major cardiovascular events.