舒洛地特治疗高龄患者慢性缺血性肾病及机制探讨  

Efficay and mechanism of Suluodexide in the treatment of chronic ischemic renal disease in elderly patients

作　　者：闫翔[1] 范惠民[1] 李钰[1] 沈桂林[1] 范萍[1] 

机构地区：[1]解放军成都军区总医院老年病科,四川成都610083

出　　处：《中国医药导报》2012年第18期83-84,共2页China Medical Herald

摘　　要：目的探讨舒洛地特治疗高龄慢性缺血性肾病的疗效及作用机制。方法 38例高龄慢性缺血性肾病(CIRD)住院患者,给予舒洛地特600 LSU,静滴,疗程20 d;然后250 LSU,口服,2次/d,序贯疗程共40 d。分别于治疗前后行颈、肾动脉超声声像和血流动力学检查,同时测定尿素氮、肌酐、一氧化氮(NO)、内皮素-1(ET-1)、血管紧张素Ⅱ(AngⅡ)。结果 CIRD患者颈动脉内膜中膜厚度增厚和斑块形成;肾动脉血流频谱特点低速高阻;ET-1、AngⅡ升高,NO下降。舒洛地特治疗后血流动力学指标明显改善,ET-1、AngⅡ明显下降,NO升高,治疗前后比较,差异有统计学意义(P<0.05)。结论高龄CIRD与动脉粥样硬化密切相关,并导致肾脏血流动力学障碍。舒洛地特通过降低ET-1、AngⅡ的分泌,升高NO含量,修复血管内皮功能,改善肾缺血缺氧,为治疗高龄CIRD的有效药物。Objective To investigate the efficacy and mechanism of Suluodexide in the treatment of chronic ischemic renal disease in elderly patients. Methods 38 cases of hospitalized elderly patients with chronic ischemic nephropathy （CIRD） were first give intravenous infusion of Suluodexide LSU 600 for 20 days and then oral intake of Suluodexide 250 LSU 2 times/d, for a sequential treatment of 40 days. Carotid artery and renal artery were tested for ultrasonography and hemody- namics before and after treatment and urea nitrogen, creatinine, and nitric oxide （NO）, endothelin -1 （ET-1） and an- giotensin Ⅱ （Ang Ⅱ ） were also tested at the same time. Results Thickening and plaque formation of intima and media of carotid artery were observed in patients with CIRD; renal artery blood flow spectrum showed the characteristics of low- speed and high-impedance; ET-1 and Ang Ⅱ increased, whole NO decreased. Hemodynamic parameters improved signifi- cantly after Suluodexide treatment, with significant increase in ET-1 and Ang Ⅱ, and significant decrease in NO （P 〈 0.05）. Conclusion CIRD in elderly patients is closely related to atheroselerosis and can lead to renal hemodynamic disor- ders. By reducing the secretion of ET-1 and AngⅡ and increasing NO, Suluodexide can recover vascular endothelial func- tion, improve renal ischemia and hypoxia and thus is an effective drug for the treatment of CIRD in elderly patients.

关 键 词：高龄患者 缺血性肾病 舒洛地特 疗效 机制 

分 类 号：R692.3[医药卫生—泌尿科学]