心得安对肾综合征出血热患者肾脏血液动力学的影响  

The Effect of Propranolol on Hemodynamics in Patients with Hemorrhagic Fever with Renal Syndrome

作　　者：王锁荣[1] 薛庆培 焦金森 孙志坚[2] 黄湘虎 姚微萱 

机构地区：[1]丹阳市人民医院,212300 [2]南京医科大学第一附属医院

出　　处：《江苏医药》1998年第6期393-395,共3页Jiangsu Medical Journal

摘　　要：观察了心得安对肾综合征出血热（HFRS）的疗效，研究了该药对患者肾脏血液动力学的影响，检测了血浆血管紧张素-Ⅱ（AT-Ⅱ）和尿素氮（BUN），部分患者还作了肾脏B超和ECT检查。结果：心得安治疗组少尿期血浆AT-Ⅱ和BUN水平均低于对照组，（分别为290．2±51．3ng／LVs338．5±84．2ng／L，P＜0．05；和25．2±9．7mmol／L，Vs33．8±11．lmmol／L，P＜0．05），多尿持续时间明显短于对照组（7．5±4．4天，VS11．3±5．8天，P＜0．05），尿蛋白消失时间亦显著快于对照组（7．5±3．7天Vs10．8±4．2天，P＜0．05）。B超显示治疗组肾肿胀程度明显轻于对照组，ECT提示治疗组肾小球滤过率（GFR）和有效肾血浆流量（ERPF）均高于对照组。以上资料表明心得安对HFRS有良好疗效。The effect of propranolol on renal hemodynamics was studied in patients with hemorrhagic feverwith renal syndrome (HFRS), and the therapeutic efficacy of this drug for HFRS was investigated, meanwhileplasma angiotensin- R (AT- Ⅱ) and blood urea nitrogen (BUN) were synchronously detected in both propranolol-treated (20mg 3 times a day) group (20 cases) and control group (17 cases). In partial cases B mode ultrasono-graphy and emmission computerized tomography were used to determine lesions in kidneys. The results showedthat after taking propranolol, plasma AT- Ⅱ 1evel decreased rapidly, the peak value of BUN was much lower inpropranolol-treated group than that in control group (25. 2± 9. 7 Vs33- 81±11.1mmol/L,P<0.05 ) and there wassignificant difference in shortening the duration of Polyuria (7. 5±4. 4Vs11.3±5. 8 days,P<0.05) and proteinuria(7. 5±3. 7 Vs 10.8±4.2 days,P<0.05) between the two groups. B mode Ultrasonography revealed that renalswelling was not as notable in proprano1ol group as in control group. Emission computerized tomography demon-strated that g1omerular filtration rate (GFR) and effective renal plasma flow (ERPF) in propranolol group weresignificantly higher than that in control group. These data suggest that proPrano1ol is of desirable efficacy in thetreatment of HFRS patients. The therapeutic mechanism may be due to the ability of β-blockade to lower sympa-thetic tensity and to inhibit renin release, and thus improve renal hemodynamics.

关 键 词：肾综合征出血热 心得安 药物疗法 血液动力学 

分 类 号：R512.805[医药卫生—内科学]