口服缬沙坦对维持性血液透析患者心功能的保护作用

目的探讨口服缬沙坦对尿毒症维持性血液透析患者心功能保护作用以及应用安全性。方法选择我院慢性肾功能不全尿毒症68例,随机分为对照组（常规治疗组）与观察组（缬沙坦治疗组）,经6个月规律血液透析治疗后,使用彩色多普勒心脏超声检查左室结构和功能,同时检测血清钾含量以及血肌酐。结果经6个月降血压及血液透析治疗后,两组收缩压、舒张压、血清钾及血肌酐水平与治疗前比较差异具有统计学意义（P〈0.01）,但组间比较,差异无统计学意义（P〉0.05）。与透析前比较,两组左心室舒张末期内径和左室重量指数透析治疗6个月后均有明显减少（P〈0.05）;但对照组室间隔厚度（IVST）、左室后壁舒张末期厚度（LVPWT）和最大血流速度比（E/A）透析前后比较差异无统计学意义（P〉0.05）,观察组透析6个月后IVST、LVPWT明显降低,E/A值显著升高,与透析前及对照组透析后比较差异均有统计学意义（P〈0.05）。结论口服缬沙坦对维持性血液透析患者心功能具有保护作用,且服用安全。

The Protective Role of Valsartan in Heart Functions in Patients Undergoing Hemodialysis

Objective To study the cardiovascular protection and safety of Valsartan in maintenance hemodialysis patients. Methods 68 patients of chronic kidney diseases were divided into two different groups： the normal control group and Valsartan group. After 6 months of redular hemodialysis, we measured the heart structures and functions of all the pa- tients using echocardiography, and examined the serum levels of Cr and K during the same time. Results After 6 months of reguler hemodialysis and redacing blood pressure, the systolic pressure, diastolic pressure, the levels of serum potassium and creatinine showed significant difference with that before treatment（P 〈 O. Ol ）, but no significant difference between the two groups （P 〉 0. 05 ）. The LVEDD and LVMI of all the patients in the two groups decreased significantly（ P 〈 0.05 ）. But IVST and LVPWT and peak velocity of the control group did not change significantly before and after hemodialysis （P 〉 0. 05 ） when compared with E/A rate and E/A rate increased only in Valsartan group, whereas these indexes did not change in control group. But in Valsartan group, IVST and LVPWT decreased significantly, E/A rate increased significantly 6 months after hemodialysis when compared with that before hemidialysis and with that after hemodialysis in control group （P 〈0. 05）. Conclusion Valsartan is safe and has a positive protective role in maintenance hemodialysis patients.