辅酶Q10联合贝那普利对血液透析患者心室重构的干预作用

发布时间：2018-05-16 18:50

本文选题：肾脏疾病 + 维持性血液透析　；参考：《山东医药》2017年01期

【摘要】：目的探讨辅酶Q10(Co Q10)联合贝那普利对维持性血液透析慢性肾病(MHD)患者心室重构的疗效及作用机制。方法选择MHD心室重构患者60例,随机分为A1组30例(联合服用Co Q10、贝那普利)与A2组30例(单独服用贝那普利);观察治疗后6个月两组患者心室重构临床疗效及血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF-α)、甲状旁腺素(PTH)、血肌酐(Cr)等生化指标的变化;使用超声心动图检测两组左心室舒张末期内径(LVDd)、舒张末期室间隔厚度(LVST)、舒张末期左心室后壁厚度(LVPWT)等心脏参数,计算左室心肌重量指数(LVMI)。结果 A1、A2组心室重构的治愈率分别为60.0%和10.0%,两组差异有统计学意义(χ2=11.237,P0.05)。A1组治疗前后LVDd、LVST、LVPWT、LVM比较差异有统计学意义(P均0.05)。治疗后A1组LVDd、LVST、LVPWT、LVMI小于A2组(P均0.05),血清hs-CRP、TNF-α水平低于A2组(P均0.05);血清hs-CRP、TNF-α、PTH、Cr水平;与LVMI呈正相关(b'分别为0.183、0.134、0.087、0.042,P均0.05),且hs-CRP、TNF-α对LVMI影响最大。结论 Co Q10联合贝那普利治疗MHD患者心室重构安全有效,其机制可能与降低血清hsCRP、TNF-α等微炎症因子水平有关。
[Abstract]:Objective to investigate the effect and mechanism of coenzyme Q10(Co Q10 combined with benazepril on ventricular remodeling in maintenance hemodialysis patients with chronic nephropathy. Methods 60 patients with MHD ventricular remodeling were selected. 30 patients in group A1 (combined with Co Q10, benazepril) and 30 patients in group A2 (taking benazepril alone) were randomly divided into two groups: the clinical effect of ventricular remodeling and serum hypersensitive C-reactive protein hs-CRP, tumor necrosis were observed 6 months after treatment. The changes of the biochemical indexes such as TNF- 伪, PTH, Cr; Left ventricular end diastolic diameter (LVDdN), left ventricular septal thickness (LVSTT) and left ventricular posterior wall thickness (LVPWTT) were measured by echocardiography, and left ventricular mass index (LVMIA) was calculated. Results the cure rate of ventricular remodeling was 60.0% and 10.0 in A _ 1A _ 2 group, respectively. The difference between the two groups was statistically significant (蠂 ~ 2 / 11.237 ~ (?) P 0.05 ~ (-1). There were significant differences in LVDdT, LVSTT, LVPWT-LVM between two groups before and after treatment (P < 0.05). After treatment, LVDdT LVPWT-LVMI in A1 group was lower than that in A2 group (P < 0.05), serum hs-CRPnTNF- 伪 level was lower than that in A2 group (P 0.05), serum hs-CRPnTNF- 伪 PTH- 伪 level, positive correlation with LVMI was 0.1830.134n0.0870.042 (P < 0.05), and hs-CRPNF-a had the greatest effect on LVMI. Conclusion CoQ10 combined with benazepril is safe and effective in the treatment of ventricular remodeling in patients with MHD, and its mechanism may be related to the reduction of serum levels of microinflammatory factors such as hsCRP- TNF- 伪.
【作者单位】：南通市第四人民医院;上海第二军医大学长征医院;
【基金】：南通市科技局社会事业科技创新与示范指令性课题(HS2014037)
【分类号】：R692.5;R54

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