缬沙坦对维持性腹膜透析患者残存肾功能的保护及对微炎症状态的影响

目的分析缬沙坦对维持性腹膜透析患者残存肾功能的保护及对微炎症状态的影响。方法选择2017年12月-2018年12月在厦门市海沧医院肾内科腹透门诊随防的维持性腹膜透析患者71例,根据治疗方法不同分为观察组39例和对照组32例,观察组患者给予缬沙坦治疗,对照组患者给予氨氯地平治疗,比较2组临床疗效、治疗前后残存肾功能(RRF)、24 h尿量、血脂指标、治疗后炎性因子水平、生活质量评分及不良反应发生情况。结果观察组总有效率为94. 87%高于对照组的78. 12%(P <0. 05)。治疗后2组RRF均低于治疗前,但观察组高于对照组,差异均有统计学意义(P <0. 05);治疗后2组24 h尿量均高于治疗前,且观察组高于对照组,差异均有统计学意义(P <0. 05)。治疗后2组HDL-C水平高于治疗前,LDL-C水平低于治疗前,且观察组HDL-C高于对照组,LDL-C低于对照组,差异均有统计学意义(P <0. 05)。治疗后,观察组CPR、IL-6、IL-8水平低于对照组,日常生活功能、心理功能、社会功能及物质生活评分均高于对照组,差异均有统计学意义(P <0. 05)。观察组不良反应总发生率为5. 12%低于对照组的25. 00%(P <0. 05)。结论对维持性腹膜透析患者采用缬沙坦治疗,不但能提高治疗安全性,促进治疗效果,还能改善患者残存肾功能,降低炎性因子水平,对于改善患者血脂水平及生活质量作用明显,值得临床推广应用。

Protective effect of valsartan on residual renal function in patients with maintenance peritoneal dialysis and its effect on microinflammatory status

Objective To analyze the protective effect of valsartan on residual renal function in patients with maintenance peritoneal dialysis and its effect on the microinflammatory state. Methods 71 patients with maintenance peritoneal dialysis were treated in the Department of Nephrology of Xiamen Haicang Hospital from December 2017 to December 2018 were selected,according to different treatment methods,they were divided into observation group(39 cases) and control group(32 cases). The observation group was treated with valsartan,and the control group was treated with amlodipine,the clinical efficacy, residual renal function(RRF) before and after treatment,24-hour urine output, blood lipid index,inflammatory factor levels after treatment,quality of life score,and adverse reactions were compared between the two groups.Results The total effective rate of patients in the observation group(94. 87%) was higher than that of the control group(78. 12%),and the difference was statistically significant(P <0. 05). The RRF of the two groups after treatment were lower than before treatment(P < 0. 05),but the observation group was higher than the control group(P < 0. 05);The 24-hour urine volume in both groups after treatment was higher than before treatment(P < 0. 05),and the observation group was higher than the control group(P < 0. 05). After treatment,the levels of HDL-C were higher than before treatment,and the levels of LDL-C were lower than before treatment,the levels of HDL-C in the observation group was higher than the control group,and the LDL-C was lower than the control group,and the differences were statistically significant(P < 0. 05). After treatment,the levels of CPR,IL-6,and IL-8 in the observation group were lower than those in the control group(P < 0. 05),and daily life function,psychological function,social function,and material life scores were higher than those in the control group(P <0. 05). The total incidence of adverse reactions in the observation group(5. 12%) was lower than that in the control group(25. 00%),and the difference was statistically significant(P <0. 05). Conclusion Using valsartan in patients with maintenance peritoneal dialysis can not only improve the safety of treatment,promote the treatment effect,but also improve the residual renal function of patients,reduce the level of inflammatory factors,and improve the blood lipid level And the effect of quality of life is obvious,it is worthy of clinical promotion and application.