苯磺酸氨氯地平对维持性血液透析患者残余肾功能的保护作用

Protective Effect of Amlodipine Amlodipine on Residual Renal Function in Patients with Maintenance Hemodialysis

目的:研究苯磺酸氨氯地平对维持性血液透析(MHD)患者残余肾功能的保护作用,为MHD患者降压方案的治疗提供依据。方法:选取2014年4月至2016年2月我院收治的MHD患者90例,按照随机数字表法分为硝苯地平组(A组)、血管紧张素抑制剂或血管紧张素转化酶抑制剂组(B组)、苯磺酸氨氯地平组(C组),每组各30例。各组分别给予相应药物进行治疗12个月,观察治疗前、治疗后6个月、治疗后12个月尿量、血生化指标、尿素清除指数(Kt/V)、残余肾尿素清除率(KRU)及心血管事件发生率。结果:治疗前各组患者尿量、KRU和Kt/V比较无统计学差异(P>0.05),治疗后3组患者尿量、KRU均显著降低(P<0.05),治疗后6个月、12个月B组和C组尿量、KRU显著高于A组(P<0.05),B组C组尿量、KRU比较无统计学差异(P>0.05),治疗后6个月、12个月三组Kt/V比较无统计学差异(P>0.05)。三组患者治疗中急性心血管事件比较无统计学差异(P>0.05),治疗后6个月、12个月A组和C组透析前高血钾发生率显著高于B组(P<0.05)。治疗前、治疗后6个月、12个月三组患者平均动脉压、脱水量比较比较无统计学差异(P>0.05)。结论:苯磺酸氨氯地平具有维持血液透析患者残余肾功能的作用,相较血管紧张素抑制剂或血管紧张素转化酶抑制剂其高血钾发生率较低,值得临床推广应用。

Objective： To study the protective effect of amlodipine on residual renal function in maintenance hemodialysis patients, and to provide the basis for the treatment of maintenance hemodialysis patients. Methods： A total of 2014 admitted to our hospital from April to 2016 Feb maintenance hemodialysis patients 90 cases, which were randomly divided into nifedipine group （group A）,angiotensin inhibitors or angiotensin converting enzyme inhibitor group （group B） and amlodipine group （group C）, each group with 30 cases. Each group were treated with corresponding drugs for 12 months, urine volume, blood biochemical indexes, urea clearance index （KW）, residual renal urea clearance rate （KRU） and cardiovascular events were observed before and after treatment for 6 months and 12 months after treatment. Results： Before treatment the urine volume, KRU and KW, is no statistical difference （P〉0.05）. The urine volume and KRU were significantly decreased in the 3 groups after treatment （P〈0.05）, after 6 months and 12 months, group B and group C were significantly higher than those in group A （P〈0.05）, there was no significant difference in urine volume and KRU between the group C and the group B （P〉0.05）, after 6 months and 12 months, there was no significant difference between the three groups KW （P〉0.05）. There was no significant difference between the three groups in the treatment of acute cardiovascular events （P〉0.05）, after treatment 6 months and 12 months group A and group C before dialysis hyperkalemia incidence was significantly higher than that in group B （P〈0.05）. Before treatment, 6 months and 12 months after treatment, there was no significant difference in mean arterial pressure and dehydration rate between the three groups （P〉0.05）. Conclusion： Amlodipine Besylate has maintenance hemodialysis patients with residual renal function, the rate is low compared to the vascular tension inhibitors or angiotensin converting enzyme inlaibitors the hyperkalemia, worthy of clinical application.