缬沙坦对尿毒症维持性血液透析患者微炎症状态的影响

Therapeutic effect of valsartan on microinflammation in maintenance hemodialysis patients

目的观察缬沙坦治疗对尿毒症维持性血液透析患者微炎症状态的影响,探讨血管紧张素Ⅱ(AngiotensinⅡ,AngⅡ)1型受体拮抗剂(AT1RA)在治疗尿毒症患者微炎症状态中的作用。方法选择哈尔滨医科大学附属第一医院肾内科维持性血液透析患者56例,测定C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平后,随机分为缬沙坦治疗组和非缬沙坦治疗组。用药后24周检查CRP、IL-6、TNF-α。并设30例健康者作对照比较。结果①尿毒症维持性血液透析患者CRP、IL-6、TNF-α显著高于健康者(P<0.01);②治疗后24周,缬沙坦治疗组CRP、IL-6、TNF-α的水平均有所下降,缬沙坦治疗组CRP、IL-6、TNF-α下降的水平与治疗前及非治疗组相比,差异具有显著性(P<0.05)。结论应用缬沙坦治疗能改善尿毒症患者的微炎症状态。

Objective To investigate the effects of valsartan on microinflammation state in maintenance hemodialysis patients. Methods In 56 patients maintenance hemodialysis patients and 30 healthy control subjects the levels of C-reactive protein （CRP）, Interlukin- 6（IL-6）, tumor necrosis factor alpha（TNF-α ） were determined, then the patients were randomly divided into 2 groups to receive valsartan 80mg daily or non-valsartan theraphy. All above parametes were assayed again after 24 weeks. Results （1）Compared with healthy people, the serum CRP, IL-6, TNF-α were elevated significantly in patients with maintenance hemodialysis. （2） After 24 weeks＇ treatment, the levels of CRP, IL-6, TNF- α in valsavtan group was lower than before, and the levels of CRP, IL-6, TNF-α were much lower in valsavtan group than nonvalsartan group （P〈 0. 05）. Conclusion Valsartan can relieve the microinflammation state in maintenance hemodialysis patients.