左旋氨氯地平对长期血液透析患者微炎症状态的影响

The Influence of Levamlodipineon on the Micro-inflammatory Statein in Chronic Hemodialysis Patients

目的:了解左旋氨氯地平对长期血液透析(CHD)患者体内微炎症状态的影响;方法:将2015年9月至2015年10月在我院血液透析中心透析超过3月的患者86例分为左旋氨氯地平组(n=44)和对照组(n=42),左旋氨氯地平组使用左旋氨氯地平降压,对照组不用任何钙离子拮抗剂降压,比较两组在入组时、第3月及第6月的妊娠相关血浆蛋白A(PAPP-A)、超敏C反应蛋白(h CRP)、白介素-6(IL-6)及白蛋白(ALB)水平,并比较各组治疗前后上述因子的水平。结果:入组时及治疗后第3、6月两组Kt/V、血压达标率及ACEI/ARB类降压药使用情况均无统计学差异(P>0.05);入组时及治疗后第3月,两组PAPP-A、h CRP、IL-6及ALB水平均无统计学差异(P>0.05);在治疗后第6月,左旋氨氯地平组PAPP-A、h CRP及IL-6水平较对照组显著降低(P<0.05);在治疗后第6月,左旋氨氯地平组PAPP-A、h CRP水平均明显低于入组(P<0.05)。结论:左旋氨氯地平能一定程度降低CHD患者体内h CRP、IL-6及PAPP–A水平,对改善微炎症状态有一定的作用。

Objective：To investigate the influence of levamlodipine on the micro-inflammatory state in chronic hemodialysis（CHD）patients.Methods：86 patients accepting hemodialysis treatment over three months in our hospital between September 2015 and October 2016 were divided into two groups：levamlodipine group（n=44）and control group（n=42）.Levamlodipine was used to depress blood pressure in the levamlodipine group,and no calcium antagonist was used in the control group.Pregnancy-associated plasma protein A（PAPP-A）,high sensitivity C reactive protein（h CRP）,Interleukin-6（IL-6）and serum albumin（ALB）were detected at baseline,the third month and the sixth month,and the results were compared between the two group and between pre-and post-treatment in each group.Results：There were no significant difference between the two groups in Kt/V,compliance with blood pressure goal and use of ACEI/ARB at baseline and the third,sixth month after treatment（P0.05）.There was no significant difference between the two groups in PAPP-A,h CRP,IL-6 and ALB at baseline and the third month after treatment（P0.05）.At sixth month after treatment,the level of PAPP-A,h CRP and IL-6 of the levamlodipine group were remarkably higher than those of the control group（P0.05）.In the levamlodipine group,the level of PAPP-A,h CRP at the sixth month after treatment were significantly lower than those at baseline（P0.05）.Conclusion：Levamlodipine can effectively decrease the level of h CRP,IL-6 and PAPP-A in patients of CHD,and it may play a role in improving the microinflammatory state in these patients.