二维斑点追踪技术评价替米沙坦对维持性血透患者的心血管保护作用

Evaluation of cardiovascular protection of Telmisartan in consecutive hemodialysis patients using 2D speckle tracking imaging

目的观察替米沙坦对维持性血透治疗的慢性肾功能衰竭(CRF)患者的心血管保护作用。方法60例维持性血透患者(血肌酐≥700μmol/L),分为治疗组(给予替米沙坦50～100mg/d)及对照组(给予尼莫地平或尼群地平)各30例,记录用药前后患者血压,二维斑点追踪技术观察用药前后患者左室基底和心尖水平内膜旋转峰值、外膜旋转峰值、平面旋转峰值及跨壁扭转峰值。结果治疗后血压,治疗组和对照组均下降(P<0.05)。治疗后心尖和基底水平内膜旋转峰值、外膜旋转峰值,平面旋转峰值、跨壁扭转峰值,治疗组和对照组均下降(P<0.05)。与对照组基底和心尖水平内膜旋转峰值、外膜旋转峰值、平面旋转峰值、跨壁扭转峰值比较,治疗12个月后,治疗组降低(P<0.05)。结论替米沙坦对行持续性血透的CRF患者具有良好的心脏保护作用,可有效改善心功能,且不依赖于其降压作用。

Objective To observe the cardiovascular protection of Telmisartanin in consecutive hemodialysis patients with chronic renal failure （ CRF ）. Methods Sixty consecutive hemodialysis patients （ serum creatinie ≥700 μmol/L） were enrolled in this study. Then they were divided into treatment group （30 cases with Telmisartan 50 - 100mg/d） and control group （30 cases with Nimodipine or Nitrendipine）. Their blood pressure （BP） before and after treatment was recorded, and their peak endomembrane rotation, peak outer membrane rotation, peak plane rotation and peak mural torsion were observed before and after treatment by speckle tracking imaging （ STI）, the peak mural torsion of left ventricular was calculated. Results After treatment, BP of treatment group and control group was decreased, while peak endomembrane rotation, peak outer membrane rotation, peak mural torsion of left ventricular were decreased （ P 〈 0.05）. There was no significant difference between the two groups before and after treatment （ P 〉 0.05 ）. Twelve months after treatment, the peak endomembrane rotation, peak outer membrane rotation, peak plane rotation, peak mural torsion and peak mural torsion of left ventricular in treatment group were significant lower than those in control group （ P 〈 0.05 ）. Conclusion Telmisartan has good cardiovascular protection in consecutive hemodialysis patients with CRF, it can improve their cardial function and doesn＇ t depend on under pressure effect.