阿托伐他汀对终末期肾脏病患者脑钠肽及心功能的影响

Atorvastatin in patients with end-stage renal disease brain natriuretic peptide and the influence of cardiac function

目的观察阿托伐他汀对终末期肾脏病(ESRD)患者脑钠肽(BNP)及心功能的影响。方法选取ESRD患者(GFR<15mL/min)38例,均未接受血液透析、腹膜透析、肾移植等肾脏替代治疗,随机分为两组,对照组给予肾功能衰竭一体化常规治疗。治疗组在对照组的基础上加阿托伐他汀20mg,每晚1次口服,连用8周。分别测定治疗前及治疗8周后血浆BNP水平,同时应用彩色多普勒超声测量患者的左室舒张末径(LVED)、左室射血分数(LVEF),并进行相关性分析。结果治疗组BNP显著低于对照组(P<0.05),治疗后两组LVED、LVEF比较,差异有统计学意义(P<0.05)。回归分析显示,ESRD患者BNP水平与LVED呈正相关(P<0.05),与LVEF呈负相关(P<0.05)。结论 BNP是反映终末期肾脏病患者心功能的敏感指标,阿托伐他汀能够显著降低BNP,降低LVED,提高LVEF,可改善心功能。

Objective To observe the influence of Atorvastatin on brain natriuretic peptide （BNP） and cardiac function of end-stage renal disease （ESRD） patients. Methods Thirty-eight ESRD patients （GFR 〈 15 mL/min） who did not accept hemodialysis, peritoneal dialysis and renal transplantation were randomly divided into two groups, control group was given renal failure conventional integration treatment. On the basis of control group, treatment group was given A- torvastatin 20 mg oral every night, for eight weeks. Plasma BNP levels were determined before treatment and eight weeks after treatment, while left ventricular end-diastolic diameter （LVED）, left ventricular ejection fraction （LVEF） and were detected by color ultrasonic, correlation between them was analyzed. Results BNP of treatment group was significantly lower than that of control group （P 〈 0.05）. LVED and LVEF of two groups compared, the differences were significant （P 〈 0.05）. Regression analysis showed that BNP level of patients with ESRD was positive correlated with LVED （P 〈 0.05）, and negatively correlated with LVEF （P 〈 0.05）. Conclusion BNP is sensitive indicators reflecting heart function in patients with end-stage renal disease, Atorvastatin can significantly reduce the BNP, reduce LVED, im- prove LVEF, can improve cardiac function.