辛伐他汀对血液透析患者血浆组织因子和组织因子途径抑制物的影响  

Effect of simvastatin on plasma tissue factor and tissue factor pathway inhibitor in hemodialysis patients

作　　者：姚律[1,2] 郝丽[1] 郭长策[2] 丁士新[2] 

机构地区：[1]安徽医科大学第二附属医院肾内科,安徽合肥230601 [2]中国人民解放军海军安庆医院肾内科,安徽安庆246003

出　　处：《河北医科大学学报》2017年第4期390-394,共5页Journal of Hebei Medical University

摘　　要：目的观察辛伐他汀对血液透析患者血浆组织因子血浆组织因子(tissue factor,TF)和组织因子途径抑制物(tissue factor pathway inhibitor,TFPI)的影响,探讨辛伐他汀在血液透析患者治疗中的应用价值。方法选择行血液透析治疗的慢性肾功能不全患者90例,依据随机数字法分为常规治疗组和辛伐他汀组,并选取同期体检的50例健康人群作为对照组,比较治疗前后TF、TFPI水平及血脂水平[三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)和低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)]变化。结果肾功能不全患者TF和TFPI水平明显高于对照组(P<0.05)。治疗后辛伐他汀组和常规治疗组TF水平明显低于治疗前,TFPI水平明显高于治疗前,辛伐他汀组TF和TPPI水平低于常规治疗组(P<0.05),辛伐他汀组和常规治疗组TG、TC、LDL-C明显低于治疗前,HDL-C明显高于治疗前,辛伐他汀组TG、TC、LDL-C明显低于常规治疗组,HDL-C明显高于常规治疗组(P<0.05),2组不良反应发生率差异无统计学意义(P>0.05)。Pearson相关性分析表明,TF、TPPI水平与TG、TC、HDL-C、LDL-C均无相关性(P>0.05)。结论 20mg辛伐他汀治疗维持性血液透析患者,能够降低TF、升高TFPI,对于纠正血液透析患者凝血功能紊乱具有重要意义。Objective To observe the effect of simvastatin on plasma tissue factor and tissue factor pathway inhibitor in hemodialysis patients, and to explore the value of simvastatin in the treatment of hemodialysis patients. Methods Ninety cases of chronic renal failure hemodialysis treatment were randomly divided into conventional treatment group and simvastatin treatment group,and 50 cases healthy people received in the same period as control group.Plasma tissue factor（TF）, tissue factor pathway inhibitor （TFPI） activity and blood lipid level triglyceride（TG） , total cholesterol（ TC） , high density lipoprotein cholesterol （ HDL-C） and low density lipoprotein cholesterol （ LDL-C ） changes before and after treatment were compared. Results TF and TFPI activity in chronic renal failure patients were significantly higher than those in control group（P〈0. 05） . TF levels after treatment in two groups were significant lowerthan before, and TFPI levels were significant higher than before, but TF and TFPI activity insimvastatin treatment group was significantly lower than conventional treatment group（P 〈 0. 05）. TG , TC and LDL-C in two groups after treatment were significantly lower than before, HDL-C was higher than before？ T G , TC and LDL-C in the simvastatin treatment significantly lower than those in conventional treatment group, and the HDL-C was significantly higher than that in conventional treatment group（P 〈0. 05） , there was no significant difference in the incidence of adverse reactions between the two groups （ P 〉 0. 05 ）. Pearson correlation analysis showed that TF and TPPI levels were not correlated with TG, TC, HDL-C and LDL-C （P 〉0. 05）. Conclusion 20 mg simvastatin treatment in maintenance hemodialysis patients can reduce the tissue factor activity,increase tissue factor pathway inhibitor level,which was important for correcting coagulation disorders in hemodialysis patients.

关 键 词：肾功能不全 肾透析 辛伐他汀 凝血致活酶 

分 类 号：R459.5[医药卫生—治疗学]