中国血液净化

中国血液净化 ›› 2015, Vol. 14 ›› Issue (01): 29-32.doi: 10.3969/j.issn.1671-4091.2015.01.008

• 临床研究 • 上一篇    下一篇

他汀类药物对中老年尿毒症患者动静脉内瘘功能的影响研究

肖胜,胡诗德,简讯,曾蜀春,杨乔岚,马懿   

  1. 川北医学院附属第二医院（四川绵阳四0四医院）肾病科
  • 收稿日期:2014-06-23 修回日期:2014-09-18 出版日期:2015-01-12 发布日期:2015-01-12
  • 通讯作者: 简讯 xun_jian404@sina.com E-mail:xun_jian404@sina.com

Effect of statins on internal arteriovenous fistuia function in elderly uremic patients

  • Received:2014-06-23 Revised:2014-09-18 Online:2015-01-12 Published:2015-01-12

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摘要： 目的研究阿托伐他汀钙对中老年尿毒症患者动静脉内瘘的作用，进一步探讨他汀类药物对其血管内膜的影响。方法选取90 例维持性血液透析的老年尿毒症患者，随机分为治疗组及对照组，各45 例。治疗组患者每晚睡前口服阿托伐他汀钙20mg,对照组未服该类药物。观察治疗组治疗前后血脂各指标变化情况。治疗组治疗前后动静脉内瘘处血管内径、内瘘口大小、血流量的变化情况。治疗组和对照组动静脉内瘘的并发症发生及内瘘功能情况。结果治疗组治疗前后胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL- C)、高密度脂蛋白(HDL- C)值比较，P＜0.05(分别为0.027、0.014、0.032、0.011),治疗组与对照组比较动静脉内瘘桡动脉内径、头静脉内径、血流量、内瘘口大小比较，P＜0.05，(依次为0.003、0.012、0.039、0.007),治疗组与对照组观察2 年后动静脉内瘘并发症发生率(分别为6.7%、55.6%) 比较，P =0.002，治疗组与对照组内瘘功能良好与内瘘失功比例分别为(97.8%，2.2%；71.1%，26.7%)，经比较P＜0.05。结论他汀类药物能够改善中老年尿毒症患者动静脉内瘘功能，延长其寿命。

关键词: 他汀类药物, 尿毒症, 动静脉内瘘

Abstract: Objective To study the effects of atorvastatin calcium on internal arteriovenous fistula in elderly uremic patients, and thereby to understand the effects of statins on vascular intima. Methods A total of 90 elderly uremic patients on hemodialysis were randomly divided into statin treatment group (n=45) and control group (n=45). 20mg of atorvastatin calcium were given orally every night to the patients in treatment group but not to those in control group. Changes of lipids indexes, vessel diameters, fistula orifice size, and blood flow were evaluated in treatment group before and after the therapy. Complications and fistula function were compared between treatment group and control group. Results In treatment group, TC, TG, LDL-C and HDL-C changed significantly after stain therapy compared to those indexes before treatment (P=0.027, 0.014, 0.032, and 0.011, respectively), diameters of radial artery and cephalic vein of the fistula, blood volume in fistula, and fistula orifice size changed significantly after stain therapy compared to those in control group (P=0.003, 0.012, 0.039 and 0.007, respectively). In treatment group and control group, fistula complications within 2 years were 6.7% and 55.6%, respectively (P=0.002), functional fistula rate was 97.8% and 2.2%, respectively (P=0.012), and dysfunctional fistula rate was 71.1% and 26.7%, respectively (P=0.027). Conclusion Statins can improve the function and lifespan of internal arteriovenous fistula in elderly uremic patients.

Key words: Statins, Uremia, Arteriovenous