坎地沙坦酯对尿毒症血液透析患者微炎症状态及心功能的影响  

The influence of candesartan cilexetil on micro-inflammatory state and cardiac function in hemodialysis patients

作　　者：安军民[1] 张莉[1] 傅艳平[1] 张锦华[1] 张媛[1] 顾雪[1] 

机构地区：[1]西安交通大学附属广仁医院肾内科,陕西西安710004

出　　处：《中西医结合心血管病电子杂志》2014年第16期173-176,178,共5页Cardiovascular Disease Electronic Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨坎地沙坦酯对尿毒症维持性血液透析患者微炎症状态及心功能的影响。方法将40例维持性血液透析患者随机分为研究组与对照组,研究组口服坎地沙坦酯8 mg/d,1次/d,观察治疗6个月,应用酶联免疫吸附实验(ELISA)法检测受试者血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、IL-18及基质金属蛋白酶(MMP-9)水平变化,彩色多普勒超声诊断仪测定两组患者左心室舒张末期内径(LVDd)、左心室收缩末期内径(LVDs)、左心室后壁厚度(LVPWT)、室间隔厚度(IVST)、左心室质量指数(LVMI)、左心室射血分数(LVEF),并对两组患者炎症因子与心功能各指标进行相关性分析。结果坎地沙坦酯组血清TNF-α、IL-6、IL-18及MMP-9水平较对照组明显降低,差异有统计学意义(P<0.05),心功能各指标较对照组明显改善,差异有统计学意义(P<0.05),血清炎症因子与心超指标相关性分析显示TNF-α、IL-6及MMP-9与LVDd、LVDs、LVPWT、IVST、LVMI呈正相关关系(P<0.05),与LVEF呈负相关关系(P<0.05);IL-18与LVDs、LVPWT、IVST、LVMI呈正相关关系(P<0.05),与LVEF呈负相关关系(P<0.05);结论坎地沙坦酯对尿毒症维持性血液透析患者心功能及微炎症状态的改善发挥重要作用。尿毒症患者血清中炎症因子水平与心功能指标变化相关。ObjectiveTo investigate the impact of candesartan cilexetil on micro-inlfammatory state and cardiac function in hemodialysis patients.MethodsThe 40 cases of hemodialysis patients were randomly divided into two groups, the study group oral candesartan cilexetil 8mg / day, 1 time / day, observed 6 months of treatment, detected serum TNF-α, IL -6, IL-18 and MMP-9 levels by ELISA. Doppler ultrasonography was used to determine LVDd, LVDs, LVPWT, IVST, LVMI and LVEF in the two groups of MHD patients. The changes of cardiac structure and function were analyzed in correlation to the changes of serum inlfammation factors.ResultsThe levels of serum TNF-α, IL-6, IL-18 and MMP-9 decreased in Candesartan cilexetil group compared to the control group （P〈0.05）, indexes of heart function significantly improved compared to the control group （P〈0.05）. Serum inflammatory factors and echocardiographic indicators of correlation analysis showed that TNF-α, IL-6 and MMP-9 was positively correlated to LVDd, LVDs, LVPWT, IVST, LVMI （P〈0.05）, and negatively correlated to LVEF （P〈0.05）; IL-18 was positively correlated to LVDs, LVPWT, IVST, LVMI （P〈0.05）, and negatively correlated to LVEF （P〈0.05）. ConclusionCandesartan cilexetil play an important role in improving micro-inlfammation and cardiac function in uremic hemodialysis patients. Levels of serum inlfammatory factors associated with changes of cardiac function in MHD patients.

关 键 词：坎地沙坦酯 尿毒症 血液透析 微炎症 心功能 

分 类 号：R459.5[医药卫生—治疗学]