中国血液净化

中国血液净化

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氯沙坦逆转维持性血液透析患者左心室肥厚与炎症和氧化应激的关系

冯丽萍    李娟娟    刘同强    冯  曦     汤京华     龚苏飞     蔡秋萍   

  1. 南京医科大学附属常州二院1肾内科  2肿瘤内科
  • 收稿日期:2012-02-17 出版日期:2012-08-12 发布日期:2012-12-24
  • 通讯作者: 刘同强
  • 基金资助:

    常州市社会发展指导项目(CS2007911)

The correlation between the effect of losartan on left ventricular  hypertrophy and the status of inflammation and oxidative stress in maintenance hemodialysis patients

  • Received:2012-02-17 Online:2012-08-12 Published:2012-12-24

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摘要： 【摘要】目的 研究氯沙坦对维持性血液透析(maintenance hemodialysis，MHD)患者左心室肥厚(left ventricular hypertrophy left ventricular hypertrophy，LVH)的影响及其与炎症和氧化应激的关系。 方法 将伴有LVH的MHD患者随机分为氯沙坦组和安慰剂组，每位患者服用氯沙坦50～100mg/日或安慰剂6个月,二维超声心动图检测心脏并计算左心室重量指数(Left ventricular mass index ，LVMI)，同时检测患者血清超敏-C反应蛋白(hs-CRP)和丙二醛(MDA)，分析左心室重量指数的变化与hs-CRP和MDA的关系。 结果 治疗后6个月，氯沙坦组左心室重量指数，血清 hs-CRP、MDA水平均降低，与治疗前比均有统计学意义(F值分别为5.13、6.14和5.47，P均＜0.01)，LVMI下降的数值与hs-CRP和MAD下降的数值均具有相关性(分别为r=0.805，t=2.91, P＜0.01和r=0.778, t=2.72, P＜0.01)；而安慰剂组以上指标与治疗前比无统计学意义(P＞0.05)。 结论  氯沙坦可逆转MHD患者LVH，改善炎症及氧化应激状态，逆转LVH的作用与改善MHD患者炎症及氧化应激状态相关。

关键词: 氯沙坦, 血液透析, 高血压, 左心室肥厚, 超声心动图

Abstract: 【Abstract】 Objective To study the effect of losartan on left ventricular hypertrophy (LVH) in maintenance hemodialysis (MHD) patients, and the correlation between the effect of losartan and the status of inflammation and oxidative stress. Methods MHD patients with LVH in our dialysis center were assigned into losartan group or placebo group. Patients took losartan 50～100 mg/d or placebo for 6 months．Left ventricular mass index (LVMI) was measured by echocardiography. Hs-CRP and MDA level were detected at the baseline, and after the treatment for 3 months and 6 months.  Results Compared the parameters at baseline condition, all parameters we tested decreased significantly after losartan treatment for 6 months, LVMI from 140.16±22.13 g/m2 to 125.21±19.39 g/m2 (F=5.13, P＜0.01), hs-CRP from 6.22±2.03 mg/L to 3.79±1.73 mg/L (F=6.14, P＜0.01), and MDA from 5.45±1.87 mol/L to 4.36±1.62 mol/L (F=5.47, P＜0.01). There was a correlation between the decrease magnitude of LVMI and the decrease magnitude of CRP or MAD (r= 0.805, t=2.91, P＜0.01 and r=0.778, t=2.72, P＜0.01, respectively). In placebo group, these parameters changed insignificantly. Conclusion Losartan is effective to reverse LVH. There is a the correlation between the effect of losartan and the status of inflammation and oxidative stress.

Key words: Losartan, Maintenance hemodialysis, Left ventricular hypertrophy, Echocardiography