厄贝沙坦对腹膜透析患者微炎症状态及残余肾功能的影响

孔祥栋　邵国民　许金华　陈肖蓉　齐　玲　邵卫红　吴思军杭州市富阳区第一人民医院肾内科，浙江杭州　311400

厄贝沙坦对腹膜透析患者微炎症状态及残余肾功能的影响

孔祥栋邵国民许金华陈肖蓉齐玲邵卫红吴思军
杭州市富阳区第一人民医院肾内科，浙江杭州311400

目的探讨厄贝沙坦对腹膜透析患者微炎症状态及残余肾功能（RRF）的影响。 方法选择2012年1月～2014年6月我院肾内科治疗的持续性非卧床腹膜透析（CAPD）患者34例，随机分为两组，对照组予常规CAPD治疗（不予应用ACEI/ARB类药物），观察组予厄贝沙坦治疗，观察两组患者治疗后RRF及血清超敏C反应蛋白（hs-CRP）的变化。 结果治疗6个月后，两组患者RRF与治疗前比较均下降明显，但观察组RRF水平显著高于对照组，差异均有统计学意义（P＜0.05），对照组治疗后6个月的血清hs-CRP与治疗前比较差异无统计学意义（P＞0.05），但观察组患者血清hs-CRP与治疗前比较下降明显，且与对照组比较明显降低，差异均有统计学意义（P＜0.05）；观察组尿量下降速率也明显低于对照组，差异有统计学意义（P＜0.05）。结论 CAPD患者应用厄贝沙坦治疗可以改善患者的微炎症状态、保护残余肾功能。

腹膜透析；微炎症状态；残余肾功能；血管紧张素Ⅱ受体阻滞剂

［Abstract］Objective To discuss the influence of irbesartan on micro-inflammation state and residual renal function （RRF）in peritoneal dialysis patients.M ethods 34 patients treated by continuous ambulatory peritoneal dialysis（CAPD）in our department from January 2012 to June 2014 were selected and randomly divided into two groups.Patients in control group were given CAPD treatment（not ACEI/ARB drugs），and patients in observation group were given irbesartan treatment.Changes of RRF and hs-CRP in both groups were observed.Results After 6 months of treatment，RRF was significantly lower than before treatment in both groups，and RRFwas significantly higher in the observation group than in the control group（P＜0.05）.Therewas no significant difference in serum hs-CRP before and after treatment in the control group（P＞0.05），while serum hs-CRP in the observation group was significantly lower after treatment than before treatment and significantly lower than that in the control group（P＜0.05）.Rate of urine volume descentwas significantly lower in the observation group than in the control group（P＜0.05）.Conclusion Irbesartan can improve themicro-inflammation state and protect the residual renal function in CAPD patients.

［Key words］Peritoneal dialysis；Micro-inflammation state；Residual renal function；AngiotensinⅡreceptor blocker

腹膜透析（peritoneal dialysis，PD）是终末期肾脏病患者一体化治疗过程中最重要的替代治疗手段之一，其与血液透析相比具有清除中分子毒素效果好、对血流动力学影响小、能更好地保护患者残余肾功能（residual renal function，RRF）等优点［1］，而RRF及微炎症状态对PD患者的生存率起重要的作用［2］。积极保护患者RRF、改善微炎症状态对PD患者的治疗具有重要意义［3］。……