冠心宁片对慢性肾衰竭血液透析合并颈动脉硬化患者粥样斑块、血液流变、血Hcy及免疫炎症的影响

Effects of Guanxinning tablet on atherosclerotic plaque,hemorheology,blood Hcy and immunoinflammation in patients with chronic renal failure and carotid artery sclerosis during hemodialysis

目的通过临床观察,观察冠心宁片对血瘀型慢性肾衰竭血液透析合并颈动脉硬化患者粥样斑块、肾功能、血液流变、血同型半胱氨酸(homocysteine,Hcy)及免疫炎症的影响。方法选择2023年1月至2024年1月丽水市第二人民医院及丽水市中医院的血瘀型慢性肾衰竭合并颈动脉硬化且正在接受血液透析患者67例,采用随机数字表法分为对照组33例和观察组34例,对照组接受慢性肾衰竭常规治疗和血液透析,观察组在基础治疗上加用冠心宁片,检测治疗前后两组颈动脉粥样硬化斑块、肾功能、血液流变学、血Hcy、免疫炎症水平。结果治疗前两组一般资料、颈动脉硬化、肾功能、血液流变学、血Hcy水平、免疫炎症水平比较,差异无统计学意义(P>0.05)。治疗后观察组缩小颈动脉斑块、改善颈动脉内中膜增厚、改善肾功能、降低炎症指标水平、提高免疫功能方面优于对照组,差异有统计学意义(P<0.05)。与对照组比较,血Hcy水平降低差异无统计学意义(P>0.05)。结论冠心宁片能改善血瘀型慢性肾衰竭血液透析合并颈动脉硬化患者的体内慢性炎症、降低血液黏度、抑制红细胞聚集,从而改善患者颈动脉硬化、缩小颈动脉硬化斑块、改善患者的肾功能、提高患者的免疫功能,但不降低血Hcy水平。

Objective To observe the effects of Guanxinning tablet on atherosclerotic plaque,renal function,hemorheology,blood homocysteine(Hcy)and immunoinflammation in patients with blood stasis type chronic renal failure complicated by hemodialysis and carotid atherosclerosis.Methods According to the diagnosis,inclusion and exclusion criteria,67 patients with blood stasis type chronic renal failure complicated with carotid atherosclerosis and undergoing hemodialysis from Lishui Second People’s Hospital and Lishui Hospital of Traditional Chinese Medicine from January 2023 to January 2024 were selected and randomly divided into control group(33 cases)and observation group(34 cases).The control group received routine treatment of chronic renal failure and hemodialysis.In the observation group,Guanxinning tablet was added to the basic treatment,and the levels of carotid atherosclerotic plaque,renal function,hemorheology,blood Hcy and immunoinflammation were detected in both groups before and after treatment.Results There were no significant differences in general information,carotid atherosclerotic plaque,renal function,hemorheology,blood Hcy level and immunoinflammation level between the two groups before treatment(P>0.05).After treatment,the observation group was superior to the control group in reducing carotid plaque,improving carotid intimedia thickening,improving renal function,reducing inflammatory index level and improving immune function(P<0.05),but there was no significant difference in reducing blood Hcy level compared with the control group(P>0.05).Conclusion Guanxinning tablet can improve the chronic inflammation in the body of patients with blood stasis type chronic renal failure combined with hemodialysis and carotid atherosclerosis,reduce blood viscosity,inhibit red blood cell aggregation,thereby improving carotid atherosclerosis,reducing carotid atherosclerotic plaque,improving renal function and improving immune function of patients,but does not reduce blood Hcy level.